ICD-10: So many questions, so few answers now

By Diana Manos
02:25 PM
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Will ICD-10 ever actually happen?

That is perhaps the most significant question since the compliance deadline was pushed back — or at least the most persistent one until Health and Human Services formally hands down a new compliance date.

And while reports were circulating on May 1 that the Centers for Medicare and Medicaid Services Inpatient Perspective Payment System (IPPS) contains language that may or may not suggest the agency is revealing October 1, 2015 as the new compliance date, as many are expecting it will, that is not the only question on the table.

At the Workgroup for Electronic Data Interchange (WEDI) emergency ICD-10 summit on April 30, in fact, a number of attendees asked a range of thought-provokers, including:

  1. How can we conduct testing for ICD-10 before everyone is ready?
  2. How can we afford to dual code … but can we even afford not to?
  3. What do you do with all of your ICD-10 staff? Keep them until a new deadline is set, or let them go?
  4. What about state-level reporting? Some states have incentives written into their laws that required ICD-10.
  5. Why should you continue to throw good money after bad with this ever-moving ICD-10 start date?

“We need a roadmap,” said Laurie Darst, revenue cycle regulatory advisor at Mayo Clinic and a WEDI ICD-10 co-chair.

Indeed, that was the point of WEDI’s event.

Most of those present said their organization was prepared to make the change by Oct. 1, 2014, and many were frustrated and outraged over the delay. Some reported losing millions of dollars as a result. Some speculated that ICD-10 would never come to pass. Still others — mainly physician stakeholders — said the industry needs to paint a better picture of the benefits of ICD-10. It seems only “the weird codes” are getting press, they said. Doctors are scared and don’t see the point.

“This has become a political war,” said Betty Gomez, vice president of IT operations at ZirMed, Inc. She urged a coming together. A peace treaty. A willingness to hear each others’ points of view.

Yet the points of view are vastly different. A large private insurer has differing concerns than a small rural physician practice. Is there any real way for them to see eye to eye?

Only the federal government has any power to do anything, and so far, they are mum on the subject. At least with regard to a start date. Stanley Nachimson, from Nachimson Advisors LLC, went so far as to say, “you don’t have to sit there and take it. Ask CMS for a different implementation date if you want it.”

Jim Daley, chair of WEDI suggested coming up with different action items for different types of organizations.

Some of the potential courses of action the group put forth included:

  • Reaching out to local medical groups to help get a better message out about ICD-10;
  • Focusing efforts on clinical improvement and how ICD-10 can help with that;
  • Keep staff that are prepared for the transition motivated and up to date on all the terminology during this delay period;
  • Meet with Congress and tell them the importance of moving forward with ICD-10;
  • Physicians need to test across all payers, not just Medicare.

WEDI officials said they expect to soon release a more definitive set of suggestions on how to survive the delay based on the combined suggestions that came out of the April 30 meeting.