ICD-10 deadline to be pushed back a year?

The U.S. Department of Health and Human Services (HHS) will reportedly announce a proposed extension of the deadline requiring healthcare providers to implement ICD-10, moving it from October 1, 2013, to October 1, 2014. The extension follows an announcement in February that HHS was postponing (actually, “initiating a process to postpone”) the compliance date.

What does this mean for healthcare providers and other organizations with skin in the ICD game? The American Medical Association (AMA) was a major proponent of the postponement and expressed their thanks for it in an official statement:

The American Medical Association appreciates Secretary Sebelius’ swift response to address the AMA’s serious concerns with ICD-10 implementation. The timing of the ICD-10 transition could not be worse for physicians as they are spending significant financial and administrative resources implementing electronic health records in their practices and trying to comply with multiple quality and health information technology programs that include penalties for noncompliance. Burdens on physician practices need to be reduced – not created – as the nation’s health care system undertakes significant payment and delivery reforms.

However, after the delay was announced, two major industry organizations pleaded with HHS to be decisive about the new date—and not to set it too far in the future. Worried about the uncertainty and risk created by a shifting deadline, the College of Healthcare Information Management Executives (CHIME) sent a letter to HHS:

We believe a prolonged delay to ICD-10 implementation, or more specifically, prolonged uncertainty about the timing and details of a delay, will create more problems than it would solve.

Recommendation: We strongly urge HHS to move quickly and decisively in setting a new compliance date for converting to ICD-10. Every day that passes without a concrete deadline is another day that should have been spent planning and implementing this critical undertaking.

We encourage HHS to remain committed to ICD-10 as many organizations have already begun substantial investments that turn wasteful if abandoned for another path. Providers have spent millions preparing for a deadline set over three years in advance. Technology has been upgraded, new processes implemented, new hires made and new education and training regimes established. This announcement has created a level of uncertainty that threatens much of the progress already made by many hospitals and clinics across the country.

CHIME also urged that payors have an earlier compliance date than providers so that systems can be tested ahead of time. The Healthcare Information and Management Systems Society (HIMSS) also urged the HHS to maintain the October 23 deadline, saying that:

HIMSS members suggest that any delay in the implementation of ICD-10 could result in additional provider costs. Examples of these costs include maintaining two separate systems, retaining the services of consultants for longer than anticipated, and re-training staff. That is on top of multi-million dollar financial investments that have been budgeted to meet the ICD-10 deadline.

Now that HHS has suggested a new deadline, stakeholders are at least out of the dark and can plan appropriately. Unfortunately, no matter what the deadline, providers (who have to substantially change their practices to incorporate the highly detailed coding system) may think it’s too soon, while payors and healthcare IT managers (for whom implementation delay drains budget dollars) may think it’s not soon enough.

Shortly before the delay was announced, Milliman released a couple of papers by consultant Patricia Zenner that provide positive solutions to this mismatch. The first covers the clinical benefits of ICD-10 implementation and aims to demonstrate that there are positive benefits for patient outcomes in moving to ICD-10 regardless of the HHS deadline. The second provides a concrete plan for helping providers make the transition to ICD-10.