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After years of telling us they are serious this time and everyone in the health care system had better be ready on time to implement the new disease coding system, CMS said today the whole project is going to be delayed indefinitely.

The new ICD-10 system requires payers and providers to convert from the old system of 13,000 codes to the new system of 68,000 codes.

All payers and providers were supposed to be ready by October 1, 2013. The acting CMS Administrator said, “There is a concern that folks cannot get their work done around meaningful use [of information technology], ICD-10 implementation, and be ready for [insurance] exchanges. So we decided to listen and be responsive.”

Apparently, a new timeline will be developed through a “rule making process.”

Fine, but that has not been the message for months now and lots of people have spent lots of money for apparently no good reason.

The concerns that particularly physicians would not be ready on time have not been minor. CMS conducted a survey between January and March of 2011 that clearly showed there were big problems ahead. But in the year since that survey, they continued to tell stakeholders to keep going ahead full speed, spending big money to be ready.

But in the last few weeks, the American Medical Association has been sounding the alarm–their people wouldn’t be ready.

Sounds like the lowest common denominator in the health care system wins out.

Here are the results from a survey CMS conducted from January to March of 2011 by type of industry participant. AHIP is the insurance industry trade association, HBMA and AAPC are associations of industry coding and billing providers, ACP is the American College of Physicians and the AMA is the American Medical Association. The survey also measured readiness for the Version 5100 standards for electronic health transactions that were effective in January 2012, but for which enforcement has been delayed until March 31, 2012.

It was obvious a year ago that the docs (ACP and AMA) weren’t going to be ready yet CMS kept telling everyone to keep spending big money on all of this.

Robert Laszweski has been a fixture in Washington health policy circles for the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. Before forming HPSA in 1992, Robert served as the COO, Group Markets, for the Liberty Mutual Insurance Company. You can read more of his thoughtful analysis of healthcare industry trends at The Health Policy and Marketplace Blog, where this post first appeared.

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13 Responses for “Oops! ICD-10 To Be Delayed Indefinitely. Never Mind!”

  1. Dr. Mike says:

    I’m so glad I went with a billing service and clearinghouse that were prepared for 5010, because now that they have taken this first step towards ICD10 billing, they are reporting that the medicare intermediary (MAC – the guys who pay me) aren’t ready and the claims aren’t getting paid. Not a single medicare check for my practice since December. Will have to take out a loan to make payroll (which of course means no check for me). Good thing I have started some projects outside of my practice – Can’t wait to close it down and do those other gigs full time – if they can’t get a simple thing like 5010 right, how bad is it going to be when icd10 hits? Not sure I want to be around to find out.

    • southern doc says:

      “I’m so glad I went with a billing service”

      ? ???

      I’m a big fan of in-house billing for small practices. We sailed through 5010 without problems, and, fortunately, haven’t wasted any time so far on ICD 10.

      • Dr. Mike says:

        Sorry, that was sarcasm. I am not at all glad. Have been thinking of bringing billing in house and may do so, but first have to decide if I even want to stay in practice, and if I do, whether or not to drop CMS related “insurance.” I don’t have the personality to be a good employed doc, but my private practice keeps getting yanked around by congress and cms every year and this is getting really tiresome.

        • southern doc says:

          If you do stay in practice, consider going non-par on Medicare. It improves the cash flow, and removes a few of the more noxious burdens.

  2. Can someone remind why we are (were) doing this ICD-10 thing?

  3. Your statement “…CMS said today the whole project is going to be delayed indefinitely” is inaccurate. Marilyn Tavenner, acting CMS Administrator, stated the ICD-10 timeline is being re-evaluated. At this time there has been no official delay in implementing ICD-10.

    It is important that people be made aware that AMA’s concerns with the October 1, 2013 implementation date have been heard and are being evaluated by CMS…however, no delay decision has been made as of today.

    Regarding the benefits of ICD-10, I recommend reading the following article:
    http://www.govhealthit.com/blog/icd-10-benefits-specific-example-improving-patient-care

  4. southern doc says:

    So I’m supposed to pay for the privilege of collecting data that “David Saintsing, director of business development at Convene Technologies” can use in his in his for-profit ventures?

    Very enrolling.

  5. Wow! I stand corrected.
    “We will reduce the diabetic epidemic in this country as a result of collecting this data”, and this is “guaranteed” too…..

  6. Nate Ogden says:

    well that was time wasted. Not as bad as when they told us to stop using people’s SSNs then as soon as we get rid of them CMS says we need to go back, collect them all and start reporting them to CMS.

    Not as frustraiting as that money spent on HIPAA so no one would send us EDI claims.

    As often as this happens you would think it would get a little more press.

  7. tcoyote says:

    This was a great decision, and the Obama administration deserves some credit for facing reality (for once). Respected hospital CIO’s were telling their colleagues that hospitals’ implementation costs were lowballed by the feds by a factor of 10. It wasn’t just physicians that were going to have problems. This was shaping up to be a monster clusterf**k.

    ICD-10 was going to cost $10s of billions of dollars and for what societal benefit? “Harmonization” of our data collection with our European brethren, lots of papers by our health services research community, and a huge pulse of stimulus spending for our IT consultancies?

    PLUS, If we’re moving away from per-incident payment, we need a coding scheme that matches where we’re heading, not where we’re leaving. . .

    Hooray for Sebelius!

  8. May I refer you to my discussion document at
    http://www.fawdry.info/eepd/01_ess/g_codes/G04_Codes.pdf

    Essential if we start to use standardised plain English Questions and answers much of our coding can be invisible. Problems come when our care of individual is secondary to coding

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