HHS Announces: ICD-10 Delayed One Year

Today the Department of Health and Human Services (HHS) announced the final rule that changes the implementation deadline for the transition to ICD-10-CM and ICD-10-PCS from October 1, 2013 to October 1, 2014. This announcement was made in the context of the rule “Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets,” which adopts the standard for a national unique health plan identifier and establishes requirements for its implementation.

The Rationale

The rule notes that, “The change in the compliance date is intended to give covered healthcare providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition by all covered entities.” The rule is scheduled to be published in the Federal Register September 5; the display copy is currently available.

The rule describes HHS’s rationale for extending the implementation time frame. HHS concluded that delaying ICD-10-CM and ICD-10-PCS by one year does the least to disrupt existing implementation efforts and minimizes the costs of delay while affording the small provider community an additional year to become compliant. To assist entities in preparing to meet the new compliance date, HHS expects to increase education and outreach events and to work with industry on improvements to the overall standards implementation process.

Cost Savings Weighed

Commercial health plans, medium and large hospitals, and large physician practices are far along in their ICD-10 implementation planning, and therefore have devoted funds, resources, and staff to the effort, according to the rule. HHS estimates a one-year delay of the ICD-10-CM/PCS compliance date would add 10 to 30 percent to the total cost that these entities have already spent or budgeted for the transition – an additional cost to commercial entities of approximately $1 billion to $6.4 billion.

While a one-year delay in the compliance date of ICD-10-CM/PCS is expected to cost the entire healthcare industry approximately $1 billion to $6.6 billion, savings are anticipated from the avoidance of costs that would occur if significant numbers of providers were unprepared for the transition to ICD-10-CM/PCS on the original compliance date of October 1, 2013. HHS estimates that there would be a cost avoidance of approximately $3.6 billion to nearly $8 billion as a result of the avoidance of two costly consequences that could occur if the original compliance date of October 1, 2013 was retained:  (1) both healthcare providers and health plans could have to process healthcare claims manually in order for claims to be paid; and (2) small healthcare providers could have to take out loans or apply for lines of credit in order to continue to provide healthcare in the face of delayed payments.

Healthcare Community Can Move Forward

AHIMA has been urging the healthcare community to continue its implementation. With this announcement, AHIMA will continue its efforts to move implementation along, with a variety of programs and projects designed to assist those implementing ICD-10-CM or ICD-10-PCS. In a press release, AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, FACHE, CAE, said, “ICD-10-CM/PCS implementation is inevitable, but today’s news gives the healthcare community the certainty and clarity it needs to move forward with implementation, testing, and training.” Thomas Gordon said, “We realize that a few are still  apprehensive about the implementation process, and that is why AHIMA remains committed to assisting the healthcare community with its transition to a new code set that will lead to improved patient care and reduced costs.”

AHIMA’s press release also noted that many academic institutions have set their curriculum for two-year, four-year and graduate programs to include the ICD-10-CM/PCS classifications, in an effort to properly prepare the next generation of HIM professionals. The HHS decision will now allow these academic programs to better plan just how ICD-10 will fit into their curriculum.

Further analysis, as well as announcements regarding programs and projects to help with implementation will be forthcoming from AHIMA.

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11 Comments

  1. In reading this article, I want to know exactly what this means. If we are schedule to take the CPC exam, which books do we use?

  2. I understand, if everything and everyone is not on the same page then don’t run the program. In a business as big as healthcare one of the major things will be cost control. To submit alot of payments to only have them rejected is not effective at all.

    But, for those who are trying to enter into the field like Sabrina and myself during these times, do we have to worry about a major update in October for the exams? I know the publication isn’t available until Nov. 1. I now this is last minute but, I was trying to submit for my RHIT online. I order the latest update for the RHIT in Feb of this year. I just want to make sure I don’t need to order another book before I try to take the test.

    Cynthia-

  3. I am preparing to take the CCA exam how does this affect the exam. Will ICD-10-CM and ICD-10-PCS be included? Which books will I need or do I need to order new ones.

    Rhonda Nichols

  4. Just like government, blame bsinuess for the high pricesThe US Judicial System is the reason why our premiums are so high. Doctors and bsinuess owners have to defend themselves from frivolous law suits. That is why we pay so much for health care.The Government will never take blame for what has happend, it will just create a new reform or bill to cover up the real reason America is failing.Want a better way of life? It takes personal responsibilty and LESS government control

  5. There has been plenty of time alotted to implement ICD-10-CM/PCS and I really don’t think this is a good excuse. The new system is easier to use; however, PCS is going to take a little getting used to. I just took a class last semester and ICD-10 makes much more sense than the current system.

    Leslie

  6. Rhonda:

    I currently have a CCA and I would guess that there would be some ICD-10-CM/PCS on the exam. Have you taken any classes?

  7. Cynthia:

    I am currently in my last semester for the Health Information Technology Program at my school and will be taking the RHIT exam probably in January. However, I have had a class in ICD-10-CM/PCS and I am sure some of this will be on the exam because AHIMA is pushing that part of the CEUs be ICD-10 CEUs when professionals are renewing their credentials.

    Leslie

  8. Sabrina:

    What book I would get would be the CPC Exam Prep book that is sold by AHIMA, but I would make sure you have ICD-10-CM/PCS books too. I am studying for my RHIT in January.

    Leslie

  9. You are all worrying about nothing. As far as certification goes and what books to use, AHIMA will and can not officially put ICD-10 on an exam until it is fully implemented, and even if they did, you can not take anything into your certification testing anyways so coding books will probably be supplied to you.

  10. I just want to let you know thatI have been in school since Jan. 2011 and we were told that the exam that we will be taking in July of 2013 will only have ICD-9 on it and all we have been taught is ICD-10. We have only 1 day so far on ICD-9 but they tell us that they would give us more our last sesmester before we graduate.

  11. I am a CCA and in maintianing my CEUs, Could someone explain hoiw amny CEUs are going to be need ed to maintain certification and when that requirement goes into ieffect and how are members going to be notified?

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