ICD-10: Reality and rhetoric
For healthcare executives and political aficionados following the latest proposed legislation that could affect ICD-10’s fate, it’s time to recognize three critical facts.
First, the proposed bills — one of which aims to kill ICD-10 outright while the other advocates a transition period — are both longshots. Second, and perhaps more important, the previous two fashions in which ICD-10 was delayed were also once considered quite unlikely. And third: Even though another delay could happen, it would be dangerous for payers or providers to bank on that and backburner the conversion.
That’s the reality. Even still, the mere mention of adjusting the ICD-10 compliance deadline sparked a real mess, rhetoric-wise, concerning the transition these past couple weeks.
Incoming president, Steven Stack, MD, trimmed the American Medical Association’s sails last week to steer AMA toward ICD-11 horizons, to which the Advisory Board Co.’s director of revenue cycle solutions rebutted: "a push to go to ICD-11 is really a push to not change at all for at least another five to seven years and most likely longer than that," Healthcare IT News sister site Healthcare Finance reported.
And then there’s the Heritage Foundation. The conservative Washington, D.C. think tank wrote a scathing response to what it considers "weak arguments for ICD-10" and essentially wrapped that around a recommendation that the U.S. "delink the disparate goals of research and reimbursement, and develop a more appropriate coding system that makes the billing process less, not more, burdensome."
Given that Republican Louisiana Senator Bill Cassidy, MD, publicly suggested to Health and Human Services Secretary Sylvia Burwell that delaying the ICD-10 penalty phase, which essentially means continuing to pay for claims coded in ICD-9, was the reasonable thing to do, a grace period is not out of the question, either. We witnessed HHS institute one to smooth the transition to HIPAA 5010, after all, proving the feds can be pragmatic when the situation demands it.
The usual suspects of ICD-10 proponents, meanwhile, have been campaigning all along that #ICD10matters, that ICD-9 is antiquated and out of codes, that a dual-coding period would be akin to yet another delay – thus we need ICD-10. Now.
[See also: Anti-ICD-10 bill gets AMA support]
Regardless of what side you’re on, where rhetoric meets reality is in the fact that we’re barely closer to squashing ICD-10 or instituting a sort of dual-coding transition period than before Republican Texas Rep. Ted Poe or Tennessee Republican Rep. Diane Black mentioned their ideas.
Either of those proposals, in fact, would still have to pass the U.S. House of Representatives and the Senate where, it’s worth noting, the Cutting Costly Codes Act of 2013 withered and lay dormant until Rep. Poe brought it back to life. And then be signed into law by President Obama.
The one action hospital CEOs, CIOs and revenue cycle directors can take now: surveillance.
Don’t stop whatever work you have in motion toward the Oct. 1, 2105 compliance deadline but keep an eye on any cues that might emerge from Congress. Summer recess, for instance, kicks off August 10 this year so if neither bill has progressed by then, there would be a short three weeks between our elected officials’ return to work on September 8 and the long-looming deadline.
This one, folks, just might come down to the wire.