Acknowledging that an interim final rule is in the works, the Centers for Medicare and Medicaid Services is inching toward definitively and officially establishing October 1, 2015, as the new ICD-10 implementation deadline.
In response to a query from Health Data Management, a CMS spokesperson provided an update on the agency's current thinking and planned approach to addressing the legally mandated one-year delay in the code switchover: On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015. Accordingly, the U.S. Department of Health and Human Services expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015.
The May 1 statement from the CMS spokesperson follows a proposed rule from the agency to revise the Medicare hospital inpatient prospective payment systems that was made available April 30 and which mentions an October 1, 2015 implementation date. In the Hospital Value-Based Purchasing Section of the preamble, the proposed rule has a Request for Public Comments on ICD-10-CM/PCS Transition, which states: The ICD-10-CM/PCS transition is scheduled to take place on October 1, 2015. After that date, we will collect nonelectronic health record-based quality measure data coded only in ICD-10-CM/PCS. In the document, CMS asks for comment on how, if at all, we should adjust performance scoring under the Hospital VBP Program to accommodate quality data coded under ICD-10-CM/PCS, or otherwise ensure fair and accurate comparisons under the Hospital VBP Program once the transition date has passed.
CMS has been under enormous pressure from industry groups, including the American Health Information Management Association and the College of Healthcare Information Management Executives, to announce October 1, 2015 as a firm date for the ICD-10 implementation. The most recent lobbying effort came in an April 24 letter to CMS Administrator Marilyn Tavenner from Premier, a collaborative healthcare alliance of more than 2,900 hospitals and nearly 100,000 other providers, which urged the agency to implement ICD-10 on October 1, 2015--the earliest it has the authority to do so--and to quickly announce this intention publicly. "Clear and early guidance from CMS will provide stability in the provider community and guarantee that healthcare stakeholders have time to exercise due diligence in preparation for implementation to begin on October 1, 2015," stated the letter to Tavenner from Premier's Senior Vice President of Public Affairs Blair Childs.
However, providers are not taking any comfort in the October 1, 2015 date--no matter what CMS eventually pronounces in an interim final rule. Cherrell Cole, HIM director for Grand River Health in Rifle, Colo., is skeptical that the new ICD-10 deadline will hold up given that CMS has proven to be powerless in the face of congressional action.
"CMS assumed they were in charge, they found out they are not," says Cole. "They now have to reconcile CMSs rules and regs with the possibility that at anytime, if needed, Congress will dump ICD-10 go live implementation and adoption into a bill to make someone happy or stop someone. How can they ever give a definitive go live date? They cant. No matter what the date that is set, we will never be able to really rely on it from now on until the date has come and gone."
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