Since 2005, there have been proposals to implement The International Classification of Diseases, 10th Revision (ICD-10) coding system. However, for the 17th time, a Sustainable Growth Rate (SGR) patch fix − SGR is the "flawed" Medicare physician payment system that rewards doctors for the number of services rendered to patients rather than providing quality healthcare care − was approved by Congress to delay a cut in Medicare reimbursements, as it finds a way to eventually repeal SGR. Though totally unrelated to ICD-10 (SGR is totally a whole different animal) there was a provision in the latest patch fix that delayed the implementation of ICD-10 for another year (Kyle Murphy, 2014). Although, many in the established medical associations seem to express their dissatisfaction with the further delay of ICD-10, there may be a hidden but a more realistic reason why Congress, who are lawmakers and are no way medical experts except maybe for a few, had to delay its implementation. The silent majority – the actual medical practitioners who toil in their clinics tending to their patients while maintaining to operate a business (waiting times at clinics could be more than two hours!) – seems not prepared at all in implementing the ICD-10 Code.
Contrasting Views on the ICD-10 Delay
According to Dr. Kyle Murphy, who wrote the article “Senate passes one-year SGR patch, ICD-10 delay bill” as posted in the EHR Intelligence website, he said “It is still unclear how delaying the ICD-10 compliance deadline became part of Section 212 of this latest SGR fix. What is clear (however) is the lack of support for the delay by provider associations.” (Kyle Murphy, 2014). The same sentiment was expressed by the American Medical Association through President Ardis Dee Hoven, MD, who, Healtcare IT News Editor Tom Sullivan says in his article “AMA explains silence on ICD-10 delay” (April 1, 2014) that AMA “did not support the bill” which Hoven described as “a fiscally irresponsible pattern of congressional procrastination that has perpetuated Medicare’s fatally flawed sustainable growth rate formula.” (Sullivan, 2014). The same frustration has been vented after a poll by the American Health Information Management Association (AHIMA) during a recent summit on ICD-10 showed that 88 percent of the respondents were “disappointed by the ICD-10 delay” since almost half (42%) has already spent more than $1 million on its implementation. (Stratton, 2014).
A week later, however, on May 1, 2014, the same AHIMA group then “applauded” the announcement by the Centers for Medicare & Medicaid Services (CMS) of the “expected interim final rule with an Oct. 1, 2015 implementation date for ICD-10-CMS/PCS (AHIMA, 2014),” making it appear that the delay may be necessary after all. AHIMA even stated in the same announcement on its website as it urged “our members to ‘stay the course’ of preparing for implementation.” Note the word “preparing.” AHIMA also said, “We particularly want to reach out to the physician community and are prepared to field support training for small physician practices proposed by CMS.” Therefore, it seems clear that “small physician practices” are still preparing or about to train their staff, if not themselves, in adopting to ICD-10. A closer look at the preparations include AHIMA advises, telling practitioners to allot 6-9 months to “become an expert in applying ICD-10-CM codes” and to “practice using the codes each week before going live.” They are also being urged to identify a “physician champion” within their practice to be the ICD-10-CM resource person who office employees will rely upon, which means one doctor in the practice may have to set aside his medical duties in order to concentrate on learning and becoming an expert in ICD-10 code alone. (AHIMA, 2012). Although this advice was released in 2012, the recent action in Congress and that latest pronouncement by AHIMA on May 1, 2014 may portray a solid basis for the delay.
As discussed in class, the ICD-10 coding system is “much more detailed and specific” compared to ICD-9. Even AHIMA stated that “payors cannot pay claims fairly using ICD-9-CM since the classification system does not accurately reflect current technology and medical treatment” (AHIMA, 2014). Personally, I have seen and used the ICD-9 book for a short medical billing course that I took, but last week’s brief immersion to ICD-10 was a eye-opener in the sense that it seems ICD-10 is much more user-friendly.
Delay May Be A Political Move vs. Obamacare; Economic Reasons and Feasibility
Personally, the action by Congress may be more of politics because of fears that the Obamacare law will ruin the entire health industry, giving less priority to the implementation of ICD-10. The Republican Party has said time and again that the law will fail because employers can’t afford it, and that a socialized healthcare program is anti-business that will affect the insurance companies big time. Their attention is more attuned to repealing it. For sure, their constituents have also voiced their concerns on shifting to ICD-10 system at a time when they are still recovering because many lost their jobs during the Great Recession and lost their health insurance while also dealing with the fact that the same Obamacare law requires them to upgrade their operations to “Meaningful Use” because of EHR or else lose their Medicare and Medicaid patients in the near future.
In another Healthcare IT News article: “ICD-10 delay upsets prepared vendors”, this time by Contributing Writer John Andres (May 1, 2014), he writes that “While there is really no way of knowing how many providers are in a position to make the ICD-10 conversion” he also said that Mike Lovett, the executive vice president and general manager of software provider NextGen Healthcare “acknowledges that some providers are behind in gearing up for the ICD-10 shift.” Andres also writes in the same article that although they too were dismayed by the delay, Athena Health said “It is alarmingly clear that healthcare is operating in an environment where there is no penalty for not being able to keep pace with necessary steps and deadlines” as expressed by its Executive Vice President and COO Ed Park – a clear indication, or an admission if you will, that many in the health industry are lackadaisical in facing the challenges of redirecting their focus on a new but much more improved coding system. Andres concludes that “there is no doubt that others will appreciate the extra time” – my own Downey-based doctor friend included, who professes that he himself doesn’t even have a computer in his clinic – as stated by MedAssets COO Mike Nolte, whose company supplies both labor and management expertise. Nolte, Andres writes, said it clearly when Nolte said that “A one-year delay provides welcome breathing room for some organizations coping with ongoing financial pressures…including − as I have suspected − complying with provisions of the Affordable Care Act and attestation for Stage 2 meaningful use” − as I’ve also stated − (Andres, 2014).
Bibliography
AHIMA. (2012). American Health Information Management Association. Retrieved May 15, 2014, from www.ahima.org: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_049471.hcsp?dDocName=bok1_049471#Champion
AHIMA. (2014, May 1). American Health Information Management Association. Retrieved May 15, 2014, from www.ahima.org: http://www.ahima.org/topics/icd10
Andres, J. (2014, May 1). Healthcare IT News. Retrieved May 16, 2014, from www.healthcareitnews.com: http://www.healthcareitnews.com/news/icd-10-delay-upsets-prepared-vendors
Kyle Murphy, P. (2014, March 31). Senate passes one-year SGR patch, ICD-10 delay bill. EHR Intelligence .
Stratton, B. (2014, April 25). www.ahima.org, Online Press Release in PDF. Retrieved May 16, 2014, from American Health Information Management Association: http://www.ahima.org/~/media/AHIMA/Files/PR/N140425%20ICD-10%20Summit%20FINAL.ashx
Sullivan, T. (2014, April 1). AMA explains silence on ICD-10 delay. (T. Sullivan, Ed.) Healthcare IT News .
Contrasting Views on the ICD-10 Delay
According to Dr. Kyle Murphy, who wrote the article “Senate passes one-year SGR patch, ICD-10 delay bill” as posted in the EHR Intelligence website, he said “It is still unclear how delaying the ICD-10 compliance deadline became part of Section 212 of this latest SGR fix. What is clear (however) is the lack of support for the delay by provider associations.” (Kyle Murphy, 2014). The same sentiment was expressed by the American Medical Association through President Ardis Dee Hoven, MD, who, Healtcare IT News Editor Tom Sullivan says in his article “AMA explains silence on ICD-10 delay” (April 1, 2014) that AMA “did not support the bill” which Hoven described as “a fiscally irresponsible pattern of congressional procrastination that has perpetuated Medicare’s fatally flawed sustainable growth rate formula.” (Sullivan, 2014). The same frustration has been vented after a poll by the American Health Information Management Association (AHIMA) during a recent summit on ICD-10 showed that 88 percent of the respondents were “disappointed by the ICD-10 delay” since almost half (42%) has already spent more than $1 million on its implementation. (Stratton, 2014).
A week later, however, on May 1, 2014, the same AHIMA group then “applauded” the announcement by the Centers for Medicare & Medicaid Services (CMS) of the “expected interim final rule with an Oct. 1, 2015 implementation date for ICD-10-CMS/PCS (AHIMA, 2014),” making it appear that the delay may be necessary after all. AHIMA even stated in the same announcement on its website as it urged “our members to ‘stay the course’ of preparing for implementation.” Note the word “preparing.” AHIMA also said, “We particularly want to reach out to the physician community and are prepared to field support training for small physician practices proposed by CMS.” Therefore, it seems clear that “small physician practices” are still preparing or about to train their staff, if not themselves, in adopting to ICD-10. A closer look at the preparations include AHIMA advises, telling practitioners to allot 6-9 months to “become an expert in applying ICD-10-CM codes” and to “practice using the codes each week before going live.” They are also being urged to identify a “physician champion” within their practice to be the ICD-10-CM resource person who office employees will rely upon, which means one doctor in the practice may have to set aside his medical duties in order to concentrate on learning and becoming an expert in ICD-10 code alone. (AHIMA, 2012). Although this advice was released in 2012, the recent action in Congress and that latest pronouncement by AHIMA on May 1, 2014 may portray a solid basis for the delay.
As discussed in class, the ICD-10 coding system is “much more detailed and specific” compared to ICD-9. Even AHIMA stated that “payors cannot pay claims fairly using ICD-9-CM since the classification system does not accurately reflect current technology and medical treatment” (AHIMA, 2014). Personally, I have seen and used the ICD-9 book for a short medical billing course that I took, but last week’s brief immersion to ICD-10 was a eye-opener in the sense that it seems ICD-10 is much more user-friendly.
Delay May Be A Political Move vs. Obamacare; Economic Reasons and Feasibility
Personally, the action by Congress may be more of politics because of fears that the Obamacare law will ruin the entire health industry, giving less priority to the implementation of ICD-10. The Republican Party has said time and again that the law will fail because employers can’t afford it, and that a socialized healthcare program is anti-business that will affect the insurance companies big time. Their attention is more attuned to repealing it. For sure, their constituents have also voiced their concerns on shifting to ICD-10 system at a time when they are still recovering because many lost their jobs during the Great Recession and lost their health insurance while also dealing with the fact that the same Obamacare law requires them to upgrade their operations to “Meaningful Use” because of EHR or else lose their Medicare and Medicaid patients in the near future.
In another Healthcare IT News article: “ICD-10 delay upsets prepared vendors”, this time by Contributing Writer John Andres (May 1, 2014), he writes that “While there is really no way of knowing how many providers are in a position to make the ICD-10 conversion” he also said that Mike Lovett, the executive vice president and general manager of software provider NextGen Healthcare “acknowledges that some providers are behind in gearing up for the ICD-10 shift.” Andres also writes in the same article that although they too were dismayed by the delay, Athena Health said “It is alarmingly clear that healthcare is operating in an environment where there is no penalty for not being able to keep pace with necessary steps and deadlines” as expressed by its Executive Vice President and COO Ed Park – a clear indication, or an admission if you will, that many in the health industry are lackadaisical in facing the challenges of redirecting their focus on a new but much more improved coding system. Andres concludes that “there is no doubt that others will appreciate the extra time” – my own Downey-based doctor friend included, who professes that he himself doesn’t even have a computer in his clinic – as stated by MedAssets COO Mike Nolte, whose company supplies both labor and management expertise. Nolte, Andres writes, said it clearly when Nolte said that “A one-year delay provides welcome breathing room for some organizations coping with ongoing financial pressures…including − as I have suspected − complying with provisions of the Affordable Care Act and attestation for Stage 2 meaningful use” − as I’ve also stated − (Andres, 2014).
Bibliography
AHIMA. (2012). American Health Information Management Association. Retrieved May 15, 2014, from www.ahima.org: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_049471.hcsp?dDocName=bok1_049471#Champion
AHIMA. (2014, May 1). American Health Information Management Association. Retrieved May 15, 2014, from www.ahima.org: http://www.ahima.org/topics/icd10
Andres, J. (2014, May 1). Healthcare IT News. Retrieved May 16, 2014, from www.healthcareitnews.com: http://www.healthcareitnews.com/news/icd-10-delay-upsets-prepared-vendors
Kyle Murphy, P. (2014, March 31). Senate passes one-year SGR patch, ICD-10 delay bill. EHR Intelligence .
Stratton, B. (2014, April 25). www.ahima.org, Online Press Release in PDF. Retrieved May 16, 2014, from American Health Information Management Association: http://www.ahima.org/~/media/AHIMA/Files/PR/N140425%20ICD-10%20Summit%20FINAL.ashx
Sullivan, T. (2014, April 1). AMA explains silence on ICD-10 delay. (T. Sullivan, Ed.) Healthcare IT News .
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