House Subcommittee Voices Support for October 2015 ICD-10 Deadline

If the House Energy and Commerce Committee’s Subcommittee on Health has its way, there will be no further delays to implementation of ICD-10. In a hearing held Wednesday, the majority of subcommittee members expressed their desire to keep the current October 1, 2015 deadline for the code switchover.  

Chairman Rep. Joseph Pitts (R-Penn.) voiced strong support for the ICD-10 transition later this year rather than another delay. “We need to end the uncertainty in my opinion and move forward to full implementation of ICD-10,” Pitts told his colleagues and witnesses at the hearing.

Likewise, Rep. Kathy Castor (D-Fla.) joined her colleagues in urging no more delays in the transition to ICD-10, with a specific appeal to congressional “leadership not to include delays in must-pass bills, especially something as important as how we pay doctors,” referring to the passage last year of the so-called “Doc-Fix” bill that suspended Medicare's sustainable growth rate formula and included a provision to delay the ICD-10 implementation by one year.

Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association, told the subcommittee that the Department of Health and Human Services has estimated a one-year delay in the ICD-10 compliance date adds a range of 10-30 percent to the total cost entities already spent or budgeted for the transition, equating to a cost of $1.1-$6.8 billion for each one-year delay.

The hearing entitled, “Examining ICD-10 Implementation,” included seven witnesses, of which only one testified in support of delaying the ICD-10 deadline. William Jefferson Terry, M.D., a practicing urologist from Mobile, Ala. testifying on behalf of the American Urological Association, urged Congress to delay implementation of the ICD-10 code set and to appoint a committee to better study the “risks and benefits.”

Terry testified that the vast majority of America’s physicians in private practice are not prepared for the Oct. 1 deadline. “If a delay is not possible, I urge you to consider legislating a dual ICD-9/ICD-10 option so that physicians will have time to transition to the new coding system especially those nearing retirement or those with a demonstrable hardship that limits their ability to adopt ICD-10 by the deadline,” according to his testimony.

Rep. Michael Burgess (R-Tex.), M.D., a member of the subcommittee, expressed his concerns about the readiness of the Centers for Medicare and Medicaid Services to meet the October 2015 ICD-10 deadline. While Burgess has “a great deal of faith” in claims processing by Medicare contractors and insurance companies and “their ability to move data,” he said that CMS appears to be the “weak link in the chain.”

From to the Sunshine Act reporting website, Burgess charged that “anytime CMS flips a switch and it involves the processing of data their systems fail.” He argued that there needs to be a contingency plan for problems that may arise starting Oct. 1, including disruptions in patient care and the inability of small physician practices to “meet their fiscal obligations that they are required to meet to stay in business.”       

However, a just-released Government Accountability Office report concluded that CMS efforts to prepare providers, clearinghouses, and health plans for the October 1 ICD-10 deadline are on track and that the agency is ready to process claims using the new codes. According to GAO, CMS has modified its Medicare systems and policies including all ICD-10-related changes to its Medicare fee-for-service claims processing systems.

“While admittedly CMS has encountered some difficulties with newly constructed consumer-facing websites, CMS has extensive experience implementing significant updates to its claims processing system,” Rich Averill, director of public policy for 3M Health Information Systems, told the subcommittee. “As the recent GAO report demonstrates, CMS has done extensive ICD-10 planning, preparation, testing and outreach.”

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