Delay of ICD-10: What Are The Consequences?

ICD-10

In March, the U.S. Senate voted to delay the mandatory implementation of ICD-10 for a year, until October 2015. This isn’t the first time it’s been done, as the Centers for Medicare and Medicaid Services (CMS) decided to do the same in 2013, giving providers and payers until 2014 to finalize their preparations.

The CMS had no intention of moving the deadline back again, but they were given no choice when The Protecting Access to Medicare Act of 2014 made it through Congress.

While the looming deadline may have been a source of stress for those struggling to comply, the delay could have some detrimental consequences, particularly for those who have made it a priority to be ready by this October.

“Many organizations have spent considerable amounts of resources, including investments in training staff and upgrading IT systems, to prepare for the conversion to ICD-10,” says Richard L. Gundling, vice president for the Healthcare Financial Management Association. “Although a delay does allow additional time for transition, it does result in a loss of momentum and will require additional costs to prepare for the conversion again one year later.”

Another challenge brought on by the delay is that organizations will now have to maintain two systems, ICD-9 and the eventually mandatory ICD-10.

“This is perhaps the hardest challenge I can think of from a project and program management perspective,” said Jordan Battani, managing director for the Global Institute for Emerging Healthcare Technologies at the consulting firm CSC. “It’s bad enough to cancel a project, but at least that means it’s over. This is the slow way down, where you have to maintain some level of focus, some level of organizational engagement with the process, because you know you’re going to have to ramp it up again.”

ICD-10: Pros and Cons

The U.S. version of ICD-10 is more elaborate, since it’s used for insurance claims and statistical tracking. Other countries usually just use it for statistical analysis. Those in favor of converting to ICD-10 say it will speed up claims processing due to the more detailed information. It’s also believed to provide deeper insight into public health trends.

However, the cost of conversion is a challenge for practices. Earlier this year, the American Medical Association (AMA) released a study stating costs could reach three times higher than previously estimated. The costs for large practices, once estimated at $2 million, may reach as much as $8 million. Included in that sum is training costs, lost productivity, testing, among others.

The latest deadline bump doesn’t mean it’s set in stone, since the law only specifies the earliest The CMS can set the deadline. However, they have communicated on their website that they “will provide guidance to providers and stakeholders soon.” Another plot twist could reveal itself if the CMS decides to just bypass ICD-10 altogether and wait for ICD-11 to be completed, which is currently under development.

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Guide: Accountable Care Organizations

Click here to download our Guide: "How Independent Practices Can Succeed in a Healthcare Industry Shaped by ACO Programs". If you would like more information you can Request a consultation.

Practice Management

  • Anesthesia Billing
  • Full-service medical billing
  • Patient account management
  • Encounter form design
  • Patient balance collections
  • Learn More

MBA In The News

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