CMS: ICD-10 Implementation Guidance Coming ‘Very Soon’

Rumors that federal health officials might make an announcement about the new ICD-10-CM/PCS implementation date at AHIMA’s ICD-10-CM/PCS and CAC Summit had been swirling for days. And those rumors continued until Denise Buenning, MsM, acting deputy director, office of e-health standards and services at the Centers for Medicare and Medicaid Services (CMS), capped off the summit with her closing presentation Wednesday afternoon.

Buenning told a rapt audience of about 200 that as of Wednesday her agency was still finalizing language that will clarify exactly when providers, payers, and vendors must transition to the ICD-10-CM/PCS code set.

Buenning and Gordon at AHIMA's ICD-10-CM/PCS and Computer-Assisted Coding Summit Wednesday

Buenning and Gordon at AHIMA’s ICD-10-CM/PCS and Computer-Assisted Coding Summit Wednesday

“What I can tell you is that we have looked at this piece of the law. We’ve sliced and diced it and had robust discussions. Where we are right now, an announcement will be made by HHS [Department of Health and Human Services] in the very near future,” Buenning said.


CMS Working through Complex Delay Process

Many in the audience were disappointed by the lack of an announcement of a solid implementation date.

During the question and answer portion of Buenning’s presentation, AHIMA CEO Lynne Thomas Gordon tried to coax Buenning into being more specific.

“If you had a crystal ball, when will you make an announcement?” Gordon asked.

Buenning replied, “When I’m on a beach in Key West.”

All joking aside, Buenning described the labyrinthine process needed for CMS to take the next steps beyond the recent ICD-10 delay and toward implementation.

“It’s been hard for us. We were surprised as all of you were when we saw it go through House and Senate. So far as we were concerned the date wasn’t changing. As far as [HHS Secretary Kathleen] Sebelius was concerned, it wasn’t changing,” Buenning said. “Given that, we already have regulatory language being drafted. My staff is doing a yeoman’s job. We’re working toward getting word out as fast as we probably can.”


AHIMA Members Get Answers

While Buenning couldn’t provide a timeline for the ICD-10 transition at this stage, she was able to clarify the extent to which CMS was prepared for the transition before this month’s Congressional action and address lingering concerns and uncertainties.

In earlier ICD-10 Summit sessions, attendees and speakers had discussed the possibility that some providers and payers might ignore the legislation delaying the ICD-10 transition and code their claims with the new code set anyway. When one audience member queried Buenning about this, she was unequivocal.

“If it’s not an adopted code set, it’s not allowed,” Buenning said.

Another audience member addressed concerns that maybe CMS wasn’t as ready for the transition as they indicated they were, especially given that end-to-end testing was only scheduled to be available on a very limited basis. Buenning mounted a strong defense of this assertion, much like her CMS colleague Godwin Odia did the day before.

“CMS was absolutely ready for October 2014, were in the 90th percentile. Our systems have been ready for over a year,” Buenning said. “The eHealth Steering Committee was ready to flip a switch.”

When asked why end-to-end testing was so limited, Buenning noted that it came down to cost. “In an ideal world, everyone would test. But in reality, the funding’s not there,” she said.


Buenning: Help Prevent Further Delays

Buenning acknowledged that the delay does impact momentum for the transition, but she called on AHIMA members to help prevent Congress from making additional attempts to block ICD-10 in the future, a possibility that keeps C-suite executives up at night.

“Work through your national associations. There’s strength in numbers. These folks work with the Hill on the daily basis and know what can be done,” she said. “Everyone perks up when the industry speaks up. CMS certainly does.”

AHIMA President and Board Chair, Angela Kennedy, EdD, MBA, RHIA, offered a similar take on Buenning’s advocacy message.

“We must continue to advocate for ICD-10 implementation. It is critical that we clearly articulate to Congress the value  and impact ICD-10 will have on population health data and the consumer,” Kennedy said.


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