Congress to Vote on ICD-10 Delay Tomorrow, AHIMA Calls for Action to Stop Bill Today



3/27/2014 11:50 a.m. CT — The US House of Representatives has passed the SGR patch bill, HR 4302, which calls for the delay of ICD-10-CM/PCS a year until October 1, 2015.  Read the full story here.  ***

A new bill has been quietly introduced into the US House and Senate that features a section calling for the delay ICD-10-CM/PCS implementation until 2015.

The bill, HR 4302 in the House and S 2157 in the Senate, which would adjust the Sustainable Growth Rate (SGR) and amend the Social Security Act to extend Medicare payments to physicians and change other provisions of the Medicare and Medicaid programs, also includes a seven line section that would delay ICD-10 to October 1, 2015.

This bill was negotiated at the leadership level in the House and Senate, and it is expected that there will be no debate before calling the bill to vote. The bill states: “The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD–10 code sets as the standard for code sets under section 1173(c) of the 13 Social Security Act (42 U.S.C. 1320d–2(c)) and section 14 162.1002 of title 45, Code of Federal Regulations.”

This bill is expected to go to the House floor on Thursday, March 27 for a vote.

AHIMA Calls on Members to Request Removal of Delay Provision

AHIMA has put out a call to members and other stakeholders to contact their representatives in Congress and ask them to take the ICD-10 provision out of the SGR bill.

When contacting Congressional members, AHIMA has instructed callers to state that their representatives/senators:

  • Oppose the specific language in the SGR patch legislation
  • Reach out to the Speaker of the House John Boehner and Senate Majority Leader Harry Reid to remove the ICD-10 language from the bill

AHIMA officials have said that another delay in ICD-10 will cost the industry money and wasted time implementing the new code set. Groups opposing ICD-10 have said that the implementation, with its large increase in codes and need to adapt healthcare systems, causes an unnecessary burden on providers.

CMS estimates that a one year delay could cost between $1 billion to $6.6 billion, according a statement from AHIMA officials. “This is approximately 10-30 percent of what has already been invested by providers, payers, vendors and academic programs in your district,” AHIMA wrote in a statement. “Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished…  Let Speaker Boehner and Senate Majority Leader Reid know that a delay in ICD-10 will substantially increase total implementation costs in your district.”

Contacting Your Congressional Representatives

For more information on contacting your representatives and senators in Congress, visit AHIMA’s Advocacy and Public Policy representative look-up site at For more information on AHIMA ICD-10 advocacy, visit



  1. to whom it may concern,
    I believe that the ICD10 should be pushed back to October 2015.
    Thank You

  2. ICD-10 implementation should not be delayed any longer.

    I believe that ICD-10 should be postponed
    until October 2015.


  4. I am requesting Congress remove the delay of ICD-10 CM/PCS provision from the SGR path legislation. The hospital/health care system I work at has already spent significant resources on training and preparing software systems for implementation on 10/1/14. Thank you.

  5. ICD-10 should be delayed,no one is prepared for ICD-10.There is a lack of staff in many practices,to implement this!

  6. I feel ICD-10 should be pushed back to October,2015.

  7. We are not well prepared for ICD 10, push it back, Wayyyy Back…

  8. I have mixed feelings on this one.
    While a delay may allow much needed time for those behind the prep curve, most likely it will only take the wind out of their ICD10 momentum sails.
    I don’t relish the conversion and its potential for reimbursement delay/revenue impact but have spent countless dollars in prep for it; really hate to see that effort put on the back shelf for another year.
    Tough either way.

  9. Do not delay the inevitable. This has been delayed long enough. I am an experienced coder and putting this off again after pouring our resources time and effort into training and preparing for the 2014 deadline we are ready to take this step and make it as painless as possible. Delaying it another year will NOT make it easier.

  10. All,

    I think those who vote “yes” on the Delay fail to realize the impact on their organization. I’m sure I can speak for others when I say organizations has spent over hundreds of thousands to millions of dollars depending on size to convert/transition. Delaying this will cost even more.

    Stop being lazy, and think about the bigger picture here!

  11. It has been delayed enough already. We just need to put it in place and start using it. I have been through training and if you have a strong ICD9 knowledge base then ICD10 will not be a problem. Therefore I am requesting Congress remove the delay of ICD-10 CM/PCS provision from the SGR path legislation

  12. No more delays!! We are so far behind the rest of the world. There has been ample time to prepare. NO MORE DELAYS!!!

  13. You can delay it all you want. Folks will continue not to take it seriously and NOT do the work get it done. Delay it till 2020 for all I care. There will never be enough money or time. The only way to get this change is to push it through and deal with the consequences as they come.

  14. enough is enough its time for ICD 10 and no more delays.

  15. Please delay; How does the government plan to pay? Transfer funds from Social Security and Medicare to implement? We are going from 13000.. numeric codes to 69000… alpha/numeric codes so the insurance companies can find another reason not to pay claims!!!!!!!!!!!!!!!!!!

  16. The hospitals have spent an extreme amount of money to implement ICD-10. Delays will cause redundant training in the future and additional future software updates due to on-going system changes. Trained coders who are now dual coding in ICD-19/ICD-10 will require retraining for 2015. This would be a costly mistake.

  17. I am not surprised by this, but I am not happy. It’s time for this to happen. All the time and money spent to this point will be for naught, and it is just something that will have to occur anyway. No more delays – keep ICD-10 on October 1, 2014.

  18. This is ridiculous either you push the ICD 10 out or you don’t, stop playing aroung and do something. Fed up

  19. There are specific evidence and enough documentation to show why any more delays to the ICD conversion is actually more costly to everyone from the public to the private sector. Why delay the inevitable and at the last hour? This is all politically driven by those who lack knowledge and understanding of how health care works. No more delays!!!!

  20. Stop the madness of trying to delay ICD 10. We need this change for so many reasons and we are ready now! To delay would be a tragedy.

  21. We have spent to much time and training on ICD 10 for us to have another delay! Lets get ICD 9 behind us and move on for goodness sake!

  22. We have gone from a nation of laws to a nation of suggestions. We pass laws and then delay them. We look stupid.

  23. PLEASE DO NOT DELAY!! Let us get on with it already. We are ready.

  24. A delay of ICD-10 now would be a catastrophic blow to the progress and investments already made in the transition! NO MORE DELAYS!!!!

  25. At this point many of us have already spent much time and money in getting ready for ICD10. If this is delayed, providers will shut down, they are not going want to hear about this again until next year. So all our efforts to this point will just have been a fruitless exercise? I cant even imagine the amount of money facilities have already put into this. Stop delaying the inevitable and lets move forward!

  26. No more delays! I agree wholeheartedly. We have been training now since September to make sure all of our Coders / Providers are prepared for this change, and it’s definately time to do it. There is no better time. There have been too many delays as is. I am beyond frustrated that this language has been slipped quietly into another bill.

  27. Are you kidding me? How irresponsible can it possibly be to stop implementation at THIS stage of the game. If this happens I swear the elected officials are the most ignorant group of people ever to walk the face of the earth. If you’re not ready, too bad. You had plenty of time.

  28. The only organization this would benefit is the AMA. They did not prepare for 2013 or 2014. What makes anyone believe that another delay would be any different?

  29. I can think of numerous reasons to delay – everyone is not ready for this major undertaking and everyone has not spent the time or resources with it looming around the corner to be ready for it this October. Physicians aren’t prepared nor are their practices ready for this kind of a change.

  30. The delay will result in the same as it did the first time. Organizations will utilize resource time for other projects and end up in the same situation they are in at present. This will result in increased cost on resource time and further delay the need for more specific documentation, for both revenue capture and the quality of patient care.

  31. The only country that does not know the US is turning into a 3rd world country is the US. This is just another example. Every other industrialized nation has been using ICD-10 since the 1990;s or early 2000’s.

  32. No More Delays!!!! HIM Professionals are ready and able to take on this challenge! We have worked very hard to provide education and work with our physicians. We have spent lots of money to get our applications ready. Lets catch up with the rest of the world. No More Excuses. Thank You

    Thank You

  33. This needs to be DElAYED…I-10 is nothing more then DATA COLLECTION.We are going from 13000 numeric codes to 69000 alpha/numeric all for DATA COLLECTION.. We do not have enough professional Coders to keep up with the backlog all of this will cause.Lets not forget reimbursement is based on the coding in America, not like in other countries where it wont matter if they are 6 months behind in coding.

  34. Stop the delay! The amount of money and time spent preparing should not go to waste. We should move forward towards the implementation THIS October.

  35. ICD-10 should not be delayed. So many efforts have been made to prepare for this transition. Let’s embrace the change…

  36. No more delays. Too much money and time has been spent by other stakeholders in ICD-10 implementation. It was delayed once before and nothing productive was done with that time. I train physicians on ICD-10 coding and its not as big a deal for them as opponents would like Congress to believe.

  37. Our small rural hospital with no money to spare will be ready because of leadership and determination. There is no excuse at this point not to be ready. We have all had the same amount of time. No delay.

  38. Please do not delay this again. Our organization has spent many hours training staff and physicians. This needs to happen!!!

  39. Delaying ICD-10 implementation again is just irresponsible action on our legislators’ part. I am totally opposed to delaying ICD-10 implementation.


  41. Either adopt it at once or dont do it at all…….there is no point of delaying and bringing up this issue every year again & again. Its been happening since last two years.

  42. We MUST NOT DELAY the implementation of ICD-10 another year. This would be financially devestating and we would sink deeper into debt. This would have a grave impact on the people of this country, Healthcare Facilities, Healthcare Providers, Insurance Providers,and the cost of healthcare in the USA.

  43. please do not delay icd 10. We have put a lot into training and can be ready for October 1, 2014.

  44. The thought of this alone is already so deflating…ridculous to say the least. Let’s keep moving forward!

  45. Everyone who is trying to post pone this is nothing but SELFISH!!!!! Get it together and suck it up! Stop ruining the future for everyone else that has made the transition, spent a lot of money and time, and are ready for ICD-10. THIS SHOULD NOT BE POST-PONED!!!!!!!!!!!!! Please.

  46. I have a feeling this is older physicians in the AMA trying to delay this yet again. I am a coder in Veteran Affairs, we have already spent millions in our system to get ICD-10 implemented (training, system updates, etc). Lets get on with this already. 10/1/2014, Lets ROCK & ROLL!!!

  47. We have nothing in place for the ICD-10 implementation. My guess, they will delay it. Most are not remotely ready. There’s been no provider education for documentation, no new medical coding training/software or new billing guidelines /forms etc at my work place.

  48. I think ICD-10 should move forward, We are so far behind the rest of the World. Move on with ICD-10, and say goodbye to ICD-9.

  49. I feel ICD-10 should NOT be pushed back to Oct 2015. We have invested alot of time and money into this. Its been going to happen and we all this close. ROLL WITH IT!!!!!!!!!!

  50. The AMA is behind this. Money talks. I’m disgusted.

  51. Too much time….Too much money!….too much anticipation and stress!!! MOVE ON ALREADY!! Rather than be in the dark we will know the ramifications and can make better use of our time working that out, live action, instead of “shooting in the dark!!!”

  52. We’re smart enough to implement the changes, If other countries could do it, we can do it even better. Don’t underestimate the negative implications of delaying this change one more time. Don’t block progress. And don’t support the delay. We can do this!

  53. No more delays. I am in training for ICD-10. I learned ICD-9 over six years ago. I would prefer to move forward.

  54. So the plan is to ignore ICD-10 for another year, forgive anyone who didn’t get a certified EHR installed, and extend the deadline for Obamacare once again. Apparently we can talk about progress, but we’re not allowed to actually make it.

  55. No more delays please. Let it be implemented as planned.

  56. I say do not delay as we have spent many hours preparing for ICD-10. There are always going to be someone who will wait til last minute to get prepared or once they stop recieving money from insurances. This is a very costly process for all facilies and many man hours have been invested. NO DELAY!!

  57. Hopefully people will take action and contact their local officials. We’ll see what happens tomorrow.

  58. I think we need to move forward in implementing ICD-10 due to the time and resources already spent in preparation. There will be many challenges to move forward but they outweigh the costs of postponing another year.

  59. I am certified, If ICD-10 is delayed it would be a blessing. So many small hospitals and Doctor offices are not ready. I work for a hospital that we are already dual coding and all of us are certified. We will not forget what we have learned even if they delay it. I think for the United States sake and economy delay it.!!!!!!

  60. If ICD 10 is delayed again we will be at this same point in 2015. Providers will still not be ready and ask for a delay until 2016 and every year after because they will never be ready. Bring on ICD 10.

  61. I cannot believe the proposal for ICD-10 delay is again rearing its head. Vendors, trainers and providers have put sweat into getting ICD-10 ready and there is absolutely no reason for the delay. The multitude of other CMS demands that are occurring this year should be delayed NOT ICD-10. We are ready for this change and we want it to occur.

  62. Why do physicians have the right to make a decision that will effect the entire nation all because they will not, and frankly I do believe that they can not, learn ICD-10-CM coding. Hire a credentialed coding expert and let them take care of the coding. Move on and implement I-10!!

  63. So many eager students have worked very hard learning ICD-10-CM in the anticipation of the many job opportunities that would result from this implementation. Delaying would be another message that as a country we don’t care about them. Do we have any idea how this delay will destroy their hopes and dreams of landing a job?

  64. I understand the provider’s frustrations. ICD-10 is controlled by four Cooperating Parties, none of whom are physicians. What is AHIMA doing to bridge the gaps? Not enough, I believe. That said, a delay is not in the country’s best interest; however I can relate to why physicians are fighting back.


  66. I am amazed at how many want to push the implementation back saying they aren’t prepared. That is no fault except their own. I have been hearing about ICD-10 since the early 90’s. We have been hearing of the implementation for about 5 years now. What will it take for those people to wake up and get prepared? It certainly isn’t because you have not heard about it.

  67. I met a woman in 2012 that talked about how she just finished her ICD-10 training. I wonder if she went back in 2013 and she’ll repeat it in 2014? Think of the financial and labor costs of getting ready only to stop short of reality. And, that’s just one person. How many delays do we need in order to be prepared? If we are not ready to take the leap now, then we will never be ready. Let’s get it over with! To those who wish for a delay, will you wait until the last minute hoping for yet another extension to 2016?

  68. Not being ready is no excuse. As ignornace of the law is no excuse. It’s hard, it’s expensive but it’s a mandate that has to happen. Spend the time and the resources NOW, and be ready. The AMA cannot hold up progess any longer. Elected officials do your duty and DO NOT allow this to happen.

  69. No more delays! Another delay is just an excuse for those who haven’t prepared. It will be the same story next year for those same people. Let’s get on with it already!

  70. DO NOT DELAY ANOTHER YEAR! All that will happen is that this time next year everyone will be complaining that they are still not ready and have not done anything about it. Those that are prepared are prepared. Let’s do this!

  71. Do not delay. We have already spent too much time and resources preparing. If we delay it will just be another reason not to be prepared in 2015. Go ahead and do it already!

  72. I cannot believe that another delay is in the works. Our coders have been preparing for this change for over two years. We are more than ready for the change! It makes me wonder what CMS has been doing the last few years. Obviously not preparing for the future.

  73. I wrote to my congress person that –
    I am a teacher in Miami Dade College, in the Medical Coder Biller Program. We have been teaching our students the new ICD-10 coding system for the past year, with the anticipation that that will be the system in the workplace. If they go into the workplace knowing ICD-10, and the coding system is still ICD-9, they will have to probably be retrained and not be ready for the workplace. This is not fair to anyone!

  74. The implementation of ICD 10 needs to be delayed. All ICD-10 has done was make companies rich. Talk about increase of health care, after all who do you think will pay the price that these physicians have taken on to convert over to ICD 10? The insurance companies are going to convert to a crosswalk while all the physician practices spend millions of dollars on training, and software. The medical coder in some associations are required to pass the ICD 10 test in order to keep their credentials. It is an endless circle. Besides the government (military base hospitals will not be using ICD 10 for at least five more years if they even do so.)

  75. We have followed the rules, we have been to the training classes and became Certified ICD-10/PCS 10 trainers the meet the demands of our organization. We have started to train our students in the colleges and the hospitals have invested in training their staff to meet the demands. Lets get moving.

  76. Do NOT Delay. We are years behind most every other country. The only one’s complaining/ wanting yet another delay are those who have not utilized their time wisely to prepare. Come on America… We ARE ready.

  77. ICD-10 has been in play for almost five years. Covered entities have spent millions upon millions to prepare. Due to political pressure the implementation was delayed for a year in 2013. Organization’s stopped working on ICD-10 and focused on other Programs. Another delay only serves to delay work, continues to reduce the credibility of HHS and CMS, and in October 2015 organizations will still be balking and asking for a delay. The industry needs to decide if they want ICD-10 or not. No Delay!!!! Get it done.

  78. What is this really about? Delaying the Affordable Care Act? A lot of Americans do not want it, so maybe this is how they will get rid of it for awhile.

  79. The US healthcare industry has invested countless hours and $$ to get ready for ICD-10. We are nearing the finish line. Do not stop or delay the race now. Those who are in favor of the delay do not want to do it and/or plan on retiring soon

    Let’s move forward with the implementation date of 1st October, 2014.

  81. The delays are usually because the government isn’t ready, NOT because the healthcare providers aren’t. This is likely the case again. Even if it is extended, your money you’ve already spent won’t be for naught. We will all eventually be required to do this. Not everyone is ready for ICD-10. Think of it as you just having extra experience and knowledge, and being even more fully prepared for the future deadline.

  82. Do we really want to be considered a backwards country? Come on, we are behind many countries already, let’s move forward with this. Delaying can only last so long and it will come to fruition eventually, let’s make it happen NOW!!

  83. The definition of insanity… doing the same thing over and over expecting a different result! This is INSANITY at its finest. If Congress was truly worried about healthcare costs, then they should not delay ICD-10. Billions of dollars have been spent by the industry expecting the implementation to happen this year. A one year delay will cost the industry money it can’t afford to waste. I know that Congress is used to wasting money, but not all of us have money to waste. If Congress truly wants to support healthcare reform, then implementing ICD-10 for better data capture is a step in the right direction. We’ll see… I’ll be watching this vote closely and the outcome will definitely effect how I vote in the next elections.

  84. The USA is already behind the rest of the world by not implementing ICD-10. We are supposed to be world-leaders and yet we are dragging our feet and keep pushing ICD-10 further out.
    Payers and providers have spent millions, if not billions, on education and system upgrades to prepare for ICD-10. We need to move forward and get ICD-10 going.

  85. Those with me who oppose any additional delay to ICD 10 . . . please go to the capwiz link provided at the end of the article and either call or write your Senator or Rep.

    Commenting on this site does little to sway those who will vote. Thanks!

  86. We need to move forward. No more delays. Lets just get on with the ICD 10. Im studying for my CCS dont need to switch back to ICD 9 it will be a total waste.

  87. To even suggest another delay is absurd! The time and effort, not to mention the millions, and millions of dollars spent on this transition….wow! Just wow! Lets move forward, and get with the rest of the industrialized world.

  88. Please consider all of the efforts and expense that have gone into preparing for ICD10 this year. Hospitals have invested time and money to partner with consultants to assist in this massive transition. Systems have been upgraded to support this endeavor. I am under contract for services with other vendors for future work this year. How will that affect these companies who have invested in training and people to support this transition. I have trained my coding staff at great expense this past year. For them not to use what they have learned will only require retraining again next year and double the expense. Please consider all of the negative consequences to delaying ICD10 once again.

  89. If the deadline is pushed to 2015 the country might as well move to ICD-11…so we’re not 15 years behind the rest of the world.

    Leave the cut-over date as is!

  90. Do not delay! The change must be made or else we might as well not even bother and stay with ICD-9 as I agree we would be having this same issue in 2015, 2016, 2017,etc. ICD-10 CM and PCS will provide much more accurate reporting for diseases and injuries. Templates, macros, etc. and assist physicians in documentation efforts. Physicians do not need to learn how to code ICD-10, they need to learn how to document to accurately reflect the condition of the patient. If that is done, then a trained coder shoud have no problem assigning the codes. As far as this being a money making scheme for companies, if we make the switch, then the need for GEMS, traning modules, instructors, materials, etc. will gradually decrease. The longer we string it out, the more intense and costly this implementation will be.

  91. Please do not delay the implemention of ICD-10 . It is time to move forward. this has beem much time & money spent in preparation for this..It has be held back once before, Please not again !

  92. As a current student for medical coding, I must say this is very frustrating. They don’t teach ICD 9 coding anymore and with another delay I will not be qualified to start looking for a job for another year? This is ridiculous. I graduate in May and want to take my certification test over the summer. There will always be an excuse, let’s get this done.

  93. I went to my first ICD-10 seminar in 1998. 1998 folks!!!!! I have been certified for two years. Am I going to have to pay over and over again to get recertified?

  94. My colleagues and I have been working tirelessly on helping facilities implement ICD-10 with the warning that no further delays will happen, per CMS. This back-handed delay is not being done for the good of Americans. It is being done because people have procrastinated for too long and are now panicking. We should not reward procrastination with yet another delay. It’s going to cost billions of dollars and put so many people who did prepare for it into a bind. This whole thing with sneaking a delay into a bill is unconscionable. I have called my representatives in Washington. Have you?

  95. Oh, so the providers are dragging their heels again, are they? What’s it going to take for them to get their act together and recognize that delaying I-10 any more is only going to cost them more money in the long run? I’ve been trying to find a way to learn I-10, but it has been a struggle because the coding system hasn’t been adopted yet and therefore people are reluctant to teach very much of it. It drives me nuts, because this makes it hard to keep my credential current. Enough nonsense- bring on I-10 !!!

  96. I have sent my opposition to delay to both my Senator and Representative. I too will watch this vote to determine how I vote in the mid-term elections. I attended training for ICD-10 in 2004. Many in other industrialized nations are ready to move to ICD 11.

    The International Classification of Diseases 11th Revision is due by 2017.

  97. No delay… JW said, if we wait until 2015 we might as well wait and move to ICD-11

  98. if ICD 10 get prosponed till 10/2015 will the CCS test too?
    I just finished school and really wanted to take ICD 9 before the transition.

  99. It will be a huge waste of money for the industry, tax payers, providers and other healthcare employees who have invested a considerable amount of $$ getting ready for October!!

  100. We should just move forward to ICD-11 and skip ICD-10.

  101. Absolutely in favor of the delay. CMS has not proven they will be ready, the carriers have not proven they will be ready. Providers have no clear vision of what the ICD-10 world will look like or that the above mentioned carriers will be able to process claims correctly. Before we relive the 5010 disaster again I would prefer claims processors prove they are able to do their job.

  102. Please do your best to take the ICD-10 provision out of the SGR bill. Face it, people who have procrastinated will only continue to put it off. Take care of those who have complied. Others will have to catch up.

  103. As an HIT student learning only ICD-10, I believe my national community of classmates join me in expressing concern over how we will prep for our RHIT and other credentialing exams should this delay sneak through. There are better and less costly alternatives to accommodate providers needing more time to adjust. The investment on the part of hospitals and other healthcare organizations, payers, government agencies, coding professionals, schools, professional organizations, and private business both in dollars and staff hours has been exhaustive. No more delays!

  104. I hope that ICD-10-CM is put off until 2015…Everybody is NOT ready…and its been said that ICD-11 is on the its way…so why not wait for ICD-11

  105. Just sent my represenative an email expressing my displeasure.

  106. This is getting ridiculous! I just sent my representative an email. I have so many clients who are just now getting around to requesting education for this very reason! All the work that has gone into preparing for the 2014 implementation will once again be delayed because nobody believes it is going to come. The more they delay, the more people believe it will NEVER HAPPEN! Marilyn Tavenner announced on February 27 that, “There are no more delays and the system will go live on October 1.” How sad if they make a liar out of her!

  107. I don’t want it pushed back but I strongly believe CMS and insurance carriers are not ready. We can’t afford a payment delay to get this process in place. It needs to be put through when it’s working and tested. At this point it’s not. So if the delay is necessary to make the system run. I would be for the delay.

  108. no one is ever ready. but given the deadline you might as well try. It is the dead line that makes us ready. if everything keeps getting pushed back you might as well not do it. As a Coder and a payer being on both ends I know how it affects us. I know if I want to be ready I will.

  109. They should allow ICD-10 codes starting October 1st, 2014 even if this bill passes for those who have worked so hard. Basically I’m suggesting that ICD-10 is phased in as a valid code set starting October 1st, 2014 and ICD-9 is phased out as a valid code set on October 1st 2015.
    I don’t even like that setup, but at least for those of us who have spend thousands of hours getting their organization ready for ICD-10, we did completely waste our time to make sure we reached the deadline.

  110. Excerpt from an article that hits the nail on the head:
    The Art of Medicine, Professionalism and ICD-10
    Written by Paul Weygandt, MD, JD, MPH, MBA, CPE
    As an educator, I often learn from my audience. Let me share with you an extremely insightful perspective of an internist at a recent presentation. Here are his words: “I get it. ICD-10 is really what we expect from our residents at morning report.” Exactly. When a resident presents a case with a general diagnosis alone, the attending physician typically inquires about etiology, clinical manifestations, anatomic specificity, laterality, and the like, which is exactly the type of information required for ICD-10 coding.
    So let me come full circle to the issues of professionalism and the “art of medicine,” and how they can be impacted by ICD-10. Diagnostic specificity in ICD-10 entices a higher level of professionalism by requiring deeper inquiry into etiology of clinical illnesses and the correlation of clinical findings to those diagnoses. Very often, the art of medicine is utilized to derive that information.

  111. If ICD-10 isn’t a good idea now, what difference will another year’s delay make? If anyone in the healthcare industry “isn’t ready” now, they never will be ready. Let’s stop delaying and not further punish those in the industry who have invested enormous time and resources doing the right things to prepare. Call your legislators and leave a message. Even though the offices are now closed, you will have an opportunity to leave a voicemail. Or email. Let’s move our profession ahead.

  112. A delay at this time will be extraordinarily costly to providers. The intent of the parties supporting the delay is not clear outside of partisan politics and the embarrassing fact that so many are not ready…however the consequences of further delay is painfully clear…additional chaos added to an already chaotic process.

  113. Absolutely in favor of the delay. CMS has not proven they will be ready and providers (NOT FACILITIES) are challenged to conduct their business with so much change.

  114. I just finished my ICD9 course and am currently taking ICD10 classes. I would like to see AHIMA still allow testing for the CCS exam in ICD9 format instead of changing it specially since there’s a chance we may be doing ICD 9 till 2015!?!? enough confusion.

  115. Shame on Congress for throwing language to delay ICD-10 by another year into this bill at the final hour. One day is not enough time to properly evaluate the impacts of this delay on each American. ICD-10-CM/PCS is vital to the modernization of our country’s model for healthcare.

    Advancement in clinical research, patient care and safety are all negatively impacted if congress passes this bill with an additional 1 year delay as a part of it. I have emailed and called all of my legislators to request they vote no on this bill until section 212 is removed. I hope all of you do the same. And I hope that AHIMA lobbies hard for an amendment to this bill if it is passed.

    I’m sure an extra year sounds nice to those of us who are falling behind on preparations for implementation of ICD-10 on 10/1/14. For those of you who think this is a good idea take off your work hat and think about this as a patient walking into a US Hospital. You may change your mind. ICD-10 has been delayed enough. Lets stop living in the dark ages and catch up with the rest of the developed world.

    If you have not yet contacted your congressional representatives stop reading this then pick up the phone, send an email or tweet your congressman to remind them not to make themistake of voting yes. Tell them to vote no for this bill until section 212 is removed!

    Thank you AHIMA for all of your hard work to keep America’s healthcare systems from failing their patients. The patient comes first and delaying ICD-10 delays the advancement of patient care and safety.

  116. PLEASE set an earler deadline for payors and a later deadline for providers!

  117. We have made major investments in staff training and computer system upgrades to be prepared for the ICD10 conversion in October 2014. To postpone this system change will prolong the process, result in increased costs,accomplish little and reward those who are unable to adapt to the future. Let’s move forward!

  118. You people don’t get it. It doesn’t matter how ready we are as providers. The issue is that CMS isn’t ready. They are no more ready for this than they were to begin enrollment for the ACA. Just try to find approved lists of payable codes for labs, radiology exams, cardiac exams, etc. they don’t exist yet. DME will be even worse.

    This is a catastrophe in the making for both patient care and reimbursement.

    Delay it. Until CMS proves THEY are ready.

  119. I called both the DC and local offices for AZ Senators McCain and Flake. I also called the local and DC office for my representative, Raul Grijalva. I sincerely hope that ICD-10-CM/PCS is not delayed. Waiting for ICD-11 is not an option, as the WHO may have it ready by 2017 but it will not be ready for use in the USA until it goes through the clinical modification and the procedure coding system is revised for the new version. Heaven only knows how long that will take. In the meantime, jobs are on the line – think of students who learned only ICD-10 and would then have to learn ICD-9-CM before being employable as coders. Think of the (literally) billions of dollars spent by healthcare organizations, vendors, insurance companies – all for nothing!?! Though of course I have no inside knowledge, I have to wonder if the AMA’s powerful lobbyists are responsible for the late night political wheeling & dealing that caused this mess. Personally, I believe the AMA is worried that at some point, PCS will be adopted as the procedure coding classification for both inpatient AND outpatient records – which would mean the cash cow that is CPT would be gone. It has been 35 years since the implementation of a new coding classification system. It is time to join the 21st century!

  120. Either we do it or we don’t! This is getting ridiculous!

  121. why do we have to wait on, (hang on) with something which has no meaning. Look even some 3rd world countries has swithed from ICD-9 to ICD-10 about 10yrs. ago, why is the United states refusing to switch? i have learned the Icd-10 coding system vividly,and come to see, know, understood it is better of a million times than the ICD-9. why because it is accurate and more specific.

  122. So, you would be willing to push forward with ICD10 even if CMS is not ready? I agree delay is not optimal. However, CMS has recently demonstrated they were not ready with the launch of the health insurance exchange. What makes you think they will be ready for accepting ICD10 claims and processing payments to physicians and hospitals in a timely manner. There is a very real possibility that another failure for CMS to implement this conversion smoothly will put many physician practices and hospitals in a position of not being able to pay their bills and meet payroll if they do not have access to large cash reserves to weather the storm. Some may even have to close their doors until CMS is back to normal operations and able to process claims timely. It doesn’t matter if physicians and hospitals are ready when CMS has not had a single on-time successful implementation of a significant nature such as the ICD9 to ICD10 conversion. CMS readiness concerns me more than physician and hospital readiness.

  123. What is the bill number? H.R. what? Nearly an hour has been spent trying to locate this information which is more time than I have to spend. Representatives need to know the number of the bill you are commenting on. Candace Miller does.

  124. Although i’m taking an icd 10 bootcamp in a few months, I’m not willing to shell out another 200 in books for the ccs exam retake since I didn’t pass the first time. I know physicians in the hospitals I work at aren’t read either. Why try implement a system that everybody is behind on?

    We might as well transition into icd11 three years from now

  125. We have been preparing for the transition, but still do not feel ready. I don’t think CMS and other carriers are completely ready either. I am in favor of a delay.

  126. Please stop this now! Ophthalmology has been targeted enough. We need to survive.

  127. Implementation of ICD-10 has NOT BEEN A SECRET! All heathcare providers knew about it AND received every resource possible to assist them. This reminds of school: the teacher puts the information on the board, gives the student a worksheet, reminds the student that a test will follow, sends additional homework assignments and the parent blames the teacher when the child fails the test.

  128. A lot of money has been spent to get us prepared for OCT 2014. We need to allow ICD-10 now, while everyone is training and preparing…..

  129. Another HIT student here. We have already begun learning ICD 10 with our coding class having 3 parts to it. I have already invested in ICD 10 books too. If you are not ready for ICD 10 why not make room for those who are. If you already know ICD 9 it should not be too hard to make the adjustment and learn ICD 10.

  130. I think its a speculation…If really gonna move to 10.2015. then better to launch the ICD11 coding systems rather than ICd10.

  131. Those of you against delaying ICD10 should articulate the direct benefit to patient care and outcomes of moving to it when ICD11 is right around the corner and already being touted as the “fix” to ICD10. Anyone?

  132. Deloris just because you are unpreparred and behind, does not mean everyone should suffer. Countless dollars and hours have already been invested in this. We are already years behind the rest of the world, the time for ICD-10 is now! If it gets delayed it will just be another glaring example of how bad politics are in this country. The way they snuck the ICD-10 paragraph into that bill is just down right dirty.

  133. Where will we be able to view the voting and results, does anyone have a link?

  134. What is really behind this delay? Whose coat pocket is Senator Coburn in?

  135. This is completely and totally unacceptable for yet ANOTHER delay for ICD-10. The ICD-9 code set is outdated. How much more can ICD-9 be updated? The rest of the world is already using ICD-10, why not the US?

  136. We have postponed ICD-10 long enough. We need to move forward with no more delays.

  137. Delores, Why not wait? ICD-10 has been used in the rest of the world for 20 years. The physicians in this country are such cry babies. Heaven forbid they have to spend some money to upgrade their offices to a more efficient system.
    I am tired of my hospital not getting reimbursed for new technology and surgeries because we don’t have codes for it.I called all of my representatives. NO Waiting! Get it done now!

  138. Please remove from the SGR bill. No more delays! Do not continue to put the U.S.A. behind in healthcare. As others have said many countries are preparing for ICD-11.

  139. This is nearing the criminal status in my opinion. We in the industry are mandated to change. It has been pushed down our throats. We have paid hundreds of thousands of dollars preparing and sacrificed numerous hours and resources in order to ‘comply’ with the mandate. Each delay reflects the poor planning of our government. The people pay, while the government delay’s. No one asked for this, but because we are law abiding and have no choice, we do what we need to do, each and every time. Why can’t government be the same? It is a do as I say, not as I do philosophy that reeks of laziness and complacency.

  140. Lets face it people Americans are afraid of CHANGE. For that reason providers are making sure that the icd-10 delayed as much as possible.One day we have to start working on i-10 if not this year may be next year but situation will be the same.

  141. Just e-mailed my representative asking that the provision be removed from the bill.

  142. It is foolish for people to suggest putting off ICD-10 and just wait for ICD-11! What makes people think that the same thing will not happen with ICD-11? Procrastination has been such a major issue and is why ICD-10 keeps getting delayed, so why would ICD-11 be welcomed with open arms? They will do the exact same things with ICD-11 and bring on the delays once again! People need to come to the realization that…change is inevitable! If people are so afraid of change, then the world of healthcare is clearly not the profession that they should be a part of!

  143. This is great news, it gives us another year to fight icd 10 which only has one benefit, that is extra room to expand, all the other supposed benefits are smoke and mirrors and not acctual benefits of icd 10. Switching to icd 10 is promoted by educational orginizations like AHIMA because they make millions on the training. If icd is so great why is it not also replaceing CPT codes? It’s all money and has no actual benefit. Also the idea that coders need extra expertise and have to use a much more complex system without a substantial raise in pay is just unfair. FIGHT ICD 10 IT COST FACILITIES, PATIENT’S, AND CODERS WAY TOO MUCH!!!!

  144. The real issue here isn’t the Dr.’s offices or the Facilities being prepared for ICD-10. It really boils down to the Medicare Contractors, CMS or the “Government” computers being ready for ICD-10. For those of us who use the Direct Data Entry System at Medicare it seems pretty obvious that system will have to be “upgraded” to process any new claims processing system. The DDE is old and I’m pretty sure there will be a “great expense” not just to CMS, but also to the Medicare contractors that they aren’t willing to invest in just yet.

  145. I see a lot of commentary on why no one wants this delay. We have already hit our physicians with EHR adoption, meaningful use, and more. Has anyone stopped to think about and remember the impact on those people who make sure we are healthy? Is the switch to ICD-10 going to make us healthier as a nation? Will it cause us to change our ways? The AMA data is compelling – we are just once again robbing Peter to save Paul and hiding behind a code set change thinking it will have a dramatic impact on things. Where’s the real evidence that it will? Or are we just continuing to fuel systems that don’t address our real issues. Diana in the above comment – If you thing a code set it going make your doctor a better diagnostician, you better get a new doctor. Doctors are not going to use the code set to determine how they practice medicine. Just some food for thought…

  146. The USA healthcare industry has had ample time to prepare for ICD-10 to include studying other nations that have been long over this hurdle, i.e., Canada, Australia, etc. Those who are choosing not to comply clearly have a strategy – spend time and money on whining and complaining to pursuade Congress to support their position rather than complying.

  147. If ICD-10 were the only change in 2014, that would be one thing. But we have four new sets of requirements: the new CQM s for MU, the new MU core measures, the new PQRS reporting and the new PV-PQRS system. I support delaying ICD-10 for another year, so that both providers and EHR vendors have time to get these other programs working well.

  148. The Republicans (who wanted this bill passed) said that there wasn’t a sufficient quorum to vote properly on HR.4302. So they put it off to the side and proceeded with other business,now what?

  149. delay until all entities are better prepared. I don’t believe CMS and others payors are ready for this huge change

  150. I just sent messages to Senators in my District. This is crazy to delay another year. I have many doctors who thought EMRs were never going to happen and now they are struggling to get up to speed. We need deadlines that are solid and make sure to hold people accountable. If we allow this to delay again we will be spending more money than ever and most independent practices are struggling too much today!

  151. We are not “rewarding procrastination” by delaying ICD-10, we are accepting the reality that healthcare has too many initiatives going on and this one was very ill-prepared for – across the board!! Why implement something that you know the majority is really not ready for? Just to spite so-called procrastinators?

    Skip ICD-10 – the country would still be behind other countries even if we implemented it today. Lets focus on ICD-11 and getting at least a bit more up to date with the rest of the world.

  152. Someone mentioned in their post that this will have a negative impact for students that have recently learned ICD-10. How about for those of us students that only learned ICD-9? We are now entering the field and not knowing ICD-10. We learned an obsolete system. We would never have an opportunity to receive a coding position because of the change over. Not to mention, that the students really don’t matter at all anyways, because none of you will hire a recent graduating student without any coding experience. Therefore, this is really a poor excuse for the issue at hand. If CMS is not ready then the system will not go accordingly as planned and the system will fail almost immediately. We are supposed to be a team in the health care industry, and as such we must work together. This is just like any other process, meaning that if part of the process is failing the rest of the process will eventually fail and have adverse effects and outcomes.

  153. 12:09:00 P.M. H.R. 4302 On motion to suspend the rules and pass the bill Agreed to by voice vote

  154. “On motion to suspend the rules and pass the bill Agreed to by voice vote”…..which means………what? they’re voting now or sometime today?

  155. So some of the stakeholders say they are not ready? It’s most fortunate that they acknowledge such.
    I’m sure there were those involved in the roll out of Obamacare who knew and said that they weren’t ready. But look what happened!

  156. The amount of time that I have been training my staff to become as prepared as possible for the 10-1-2014 live date is quite large as I know other acute care facilities are also spending so much time and energy on training/teaching and testing. We would have to start all over again next year. Medicare has allowed us to start submiting claims for testing. How about we just get it over with and go live October 1, 2014. Just do it already!

  157. Do not delay the ICD 10 implementation, since we are ready for the launch in Oct 1 2014. The people who are not ready this year will not get ready for next year too. Please implement.

  158. Students wouldn’t be hurt, our local college teaching health information management is teaching both I-9 and I-10, also the comment about no one hiring students without experience is off track too. Almost all of the people I work with were hired as new graduates, we are a large organization and just a few were hired with experience. We train our new people onsite to our organizational rules as well as compliance with Medicare and Medicaid rule.

  159. my daughter will be graduating from college may of 2014 inwith a degree in HIM they have learned nothing but icd10 coding . she is very worried along with all the the other students in her class that a job will not be avaiable because of this delay not to mention all the tution she and me as a parent have paid for her college degree .

  160. Really people…..delay another year… you realize how much money has been spent in preparing for ICD10? CMS estimates a 1 year delay would cost between 1-6.6 billion dollars. This is not about making your doctor a better doctor (diagnostician)…it is about capturing all the issues a patient has during his hospital stay that affects his ROM (risk of mortality) and SOI (severity of illness)….all it basically boils down to is more specificity of a diagnosis. Also, I think it was pretty “dirty” to “slip” this in at the last minute….but then again we are talking about our United States Government…

  161. We are the last industrialized country to do this, we are stuck with old ICD9 codes. Other first rate countries have to dumb down from ICD10 to ICD9 to compare data. It is sad considering USA is a leader in Medical advances.

  162. As an employee that works for a company that is prepared I am excited to begin ICD-10. I am aware of the time and energy that the management have put in to meet the October 1, 2014 deadline. Now we will be rewarding people/companies who didn’t take the time to do their homework.

  163. There seems to be two camps here. Those that use the codes are ready and those that implement and pay for the systems that handled the processing of the codes that are not ready. I can tell from experience it takes A LOT more effort and money to change the systems over to handle this. I don’t know why everyone is in a hurry for this anyway…I really don’t care what the rest of the world is doing. You should all be concerned about how these new classifications will be used to control your access to healthcare…not improve it.

  164. The concern expressed by many, including the physicians, that the US has too many competing initiatives has merit. However, Congress has been cognizant of the myriad requirements for healthcare from the beginning when they approved the mandate. So, what has given them (the same Congressional team) enlightenment six months prior to the deadline?
    Congress has followed the progress of ICD-10 implementation (WEDI, AHIMA, HIMSS and multiple others that have testified), aware of the billions of dollars being spent for the transition. Congress’ behavior today is disrespectful to everyone involved in healthcare and demonstrates extreme lack of fiduciary responsibility.
    Everyone can follow the law. Congress: decide on the one that you want healthcare workers to follow. If you jump in the water, swim or leave the ocean to the committed.

  165. I am against delay of ICD-10. All US Colleges teach ICD-10 from September 2013. We will have shortage of ICD-9 coders and excess ICD-10 coders. We are ready for a change to ICD-10.

  166. I for one am greatly disappointed in the delay, but I speak for a tiny minority of practitioners, International Board Certified Lactation Consultants, who will be greatly harmed by this delay. The Affordable Care Act, in theory, should have enhanced our ability to get reimbursed since the Surgeon General endorsed our profession as the one with specialized expertise in managing serious breastfeeding problems. Nevertheless, the ICD-9 codes are abysmally inadequate for coding in comparison with the new ICD-10 codes. We, as a profession actually are ready and chomping at the bit to move forward to more appropriate codes.

  167. Where can I find the estimate CMS (the actual CMS source)? I would like to site that information in a blog I am writing. Thanks.

  168. I am working nationwide to educate home care agencies on the use of ICD-10-CM, and so far the feedback has been very positive regarding the change from ICD-9-CM. Because of the expanded codes, it is much easier to find codes for many of the diseases we use in Home Health Care. The use of ICD-10 in home care helps us paint a more clear picture to our MACs and surveyors as to what we are doing for our patients. I am highly disappointed in the possible delay AGAIN in implementing ICD-10-CM. Agencies are ready; Home Care agencies are having to do more and more for beneficiaries with less and less resources. It is completely unfair to those who are training and preparing to have to push this to the back burner for another year.

  169. I have been ready fir ICD10 since last year, just part of con-tinuing eduation but I am not convinced the Health System in general is ready, this includies coders, physicians, insurance and other entities. This is not just about coders and I feel like the delay is quite reasonable to insure the best outcome.

  170. It is critical that the US at least try to catch up with the rest of the world. I-9 is becoming more out of date as I write this email, for medical data and patient care purposes the specificity offered by ICD-10 is much needed. The healthcare industry as a whole has spent countless hours and dollars in preparation for I-10 and it’s time has come. Another delay will continue to erode our momentum and what little buy in we have with physicians. The squeeky while doesn’t always have to get the oil, the AMA needs to not get their way on this one and realize we need to come out of the dark age with our data capture.

  171. As a coder/biller of small physician practices we will be ready by 10/1/14. The problem is, the clearinghouse/insurance carriers that have to add all of the codes not just specific to a specialty. I have been waiting a week for my clearinghouse to do mapping for the qualifier for box 17 for the April 1 deadline. I have a weeks worth of claims sitting in a holding file. This is what will happen to everyone come 10/1/14 if the above mentioned entities aren’t ready. Here in Missouri we already have to wait 32 weeks to be paid on State of IL claims due to their financial mess. Small physician practices cannot afford to not be paid for 90 days or more as the “industry” predicts will happen. We have felt the impact of the “Obamacare” and the huge deductibles patients now have that we have to collect instead of receiving payment from insurance carriers. There has to be steps put in place to make sure the clearinghouses/insurances carriers are able to process the claims in a timely fashion for the providers who are ready.

  172. The US must get with it! we cannot delay ICD-10!! Specific data collection is needed in this country now!!

  173. This bill is NOT about ICD-9 to ICD-10 transition it is about SGR and they only reason this issue was placed in the bill was to throw the AMA a polticial bone in hopes that they would go along with another bandaid policy to fix a very flawed system for setting Medicare’s fee schedule. This truly is not about a delay in implementation of ICD 10. Congress has no real skin in that ICD 10 game. It’s about Medicare payements for the next year and it is called a MID TERM election year.

  174. My institution has no doubt hundreds of thousands of dollars to be ready for ICD-10. If it wasn’t going to go congress should have stopped it 2 years ago. 6 months ahead is costing us millions in wasted healthcare dollars already spent. One small peice of our cost is 60 coders coworkers were just trained at the cost of $500 a piece. Our company waited until a couple weeks ago so the training would be fresh and now what if it is delayed?

  175. Don’t stop ICD10! It is critical that we continue forward. Let us not forget what happened with the metric system. Data collection is needed in this country NOW! Let us be PROgressive, not REgressive.

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