ICD 10 Delay Indefinate

icd10After years of telling us they are serious this time and everyone in the health care system had better be ready to implement the new disease coding system, on April 1st, CMS said the whole project is going to be delayed indefinitely.  Despite the date, they weren’t joking.  Secretary Kathleen Sebelius announced President Obama had signed into law the Protected Access to Medicare Act of 2014 effectively delaying the ICD-10 implementation again.  This time, indefinitely.

The new ICD-10 system would have require payers and providers to convert from the old system of 13,000 codes to the new system of 68,000 codes, but Secretary Sebelius delayed the change to an unspecified date. She called the ICD-10 codes “important to many positive improvements in our health care system,” but said HHS had heard from many physicians “who have concerns about the administrative burdens they face in the years ahead. We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.” The official decision came two days after Acting Centers for Medicare & Medicaid Services (CMS) Director Marilyn Tavenner told the American Medical Association’s National Advocacy Conference that CMS would “reexamine the [ICD-10] timeframe.”

All payers and providers were supposed to be ready by October 1, 2013. The acting CMS Administrator said, “There is a concern that folks cannot get their work done around meaningful use [of information technology], ICD-10 implementation, and be ready for [insurance] exchanges. So we decided to listen and be responsive.”  According to Secretary Sebelius, a new timeline will be developed through a “rule making process.”

Health care providers across the nation were frustrate by the news, because that is opposite of the message heard for months, so now lots of people have spent lots of money for apparently no good reason. According to Joan Usher, President, JLU Health Record Systems, however, health care providers like home care should stay the course….

Top 4 Myths About the Delay:

1. It is not going to change until October 1, 2015, there is plenty of time.

In reality, many organizations were finding that much more documentation is needed and they are not currently getting this information from the referral source.

Action Item: Use this time to educate the referral sources. In addition, take advantage of the delay and re-look at forms and EHR templates to target data collection for code specificity in ICD-10.

2. Hold off on training, as staff will not retain information until 2015.

Continue to train Coding, Intake and Quality Improvement Staff as productivity studies predict a 30 – 50 % decrease in review of coding and OASIS. Don’t limit training to Coding staff. Make small day to day changes now with Intake and Clinicians that will be needed in ICD-10 such as the identification of initial/subsequent treatment, laterality, location (upper, lower, quadrant) and depth (ulcer documentation). Target problematic areas for training; if it doesn’t work well in ICD-9 it won’t work well in ICD-10 either.

Action item: Practice makes perfect.

3. Staff are proficient in ICD-9 so ICD-10 will require minimal training.

Now is the time to establish proficiency and CONSISTENCY among different staff. Look at your top diagnoses and how they translate in ICD-10; establish protocol for those that are not one to one translation.

Action Item: Test staff on ICD-9 and establish a baseline so all staff will code the same in ICD-10 (since there are 4 times the number of code choices).crazy

4. Crazy Times!,   Change in Mental Status R41.82

JLU provides Training on ICD-9 and ICD-10 Preparedness and Coding. We also have Coding Competency Tests for Home Health & Hospice available. Click here to see our class offerings.

Joan Usher
JLU Health Record Systems