The Department of Health and Human Services has extended the deadline for converting from the ICD-9 to ICD-10 disease and billing coding set by two years – from Oct. 1, 2011 to Oct. 1, 2013.
Industry insiders received the government announcement last month with mixed reaction – some breathed a sigh of relief, while others expressed disappointment at the delay.
“This further extension means more years without the data needed to make intelligent data-driven decisions related to all aspects of healthcare,” said Linda Kloss, American Health Information Management Association CEO. “Nonetheless, this extra time gives the industry no excuse for an adequate implementation and compliance.”
Reed E. Pew, CEO and president of the American Academy of Professional Coders, expressed the stance that several insurers and several physician groups, including the Medical Group Management Association, had taken with the proposed 2011 deadline.
“We believe this delay is a victory for providers, payers and coders and allows for a more efficient transition, giving the proper amount of time to implement system and coding changes without impacting the daily operations of practices, facilities and payers.”
ICD-9 contains 17,000 codes and is expected to start running out of available codes next year. The ICD-10 code sets contain more than 155,000 codes.
According to a study initiated by a broad group of provider organizations and conducted by Nachimson Advisors, the cost for a 10-physician practice to implement ICD-10 is estimated at more than $285,000.
The estimate includes the cost of training expenditures, new claim forms software, business process analysis, practice management and billing software upgrades, increases in claim inquiries and reduction in cash flow and increased documentation costs.
Officials from the American Academy of Professional Coders said the transition to ICD-10 will require doctors to learn a more extensive way of documenting their work, or they could face losing reimbursements.
“The increased granularity of the coding and the sharp increase in the complexity and number of codes themselves will be pretty stunning,” said Sheri Poe Bernard, head of the American Academy of Professional Coders’ national advisory board.
“The last time we had anything this big was 30 years ago when ICD-9 codes were first required on paper claims,” she said.
HHS last month released the new ICD-10 code set and an updated X12 standard, Version 5010, for certain electronic healthcare transactions; an updated version of the National Council for Prescription Drug Programs (NCPDP) standard, Version D.0, for electronic pharmacy-related transactions; and a standard for Medicaid pharmacy subrogation transactions.
HHS extended the deadline for X12 standard, Version 5010 by 21 months to Jan. 1, 2012. Small health plans have a compliance deadline for X12, Version 5010 of Jan. 1, 2013.