ICD-10 Delay Hurts Those Who Would Be Ready

The Centers for Medicare and Medicaid Services spent many months telling stakeholders that the ICD-10 compliance deadline was firm–even before the agency had done its own testing. Now that Congress, with a push from physician groups, has delayed the compliance date at least another year, it is providers, payers and vendors that were on schedule to be ready that will be the ones being punished.


The Centers for Medicare and Medicaid Services spent many months telling stakeholders that the ICD-10 compliance deadline was firm--even before the agency had done its own testing. Now that Congress, with a push from physician groups, has delayed the compliance date at least another year, it is providers, payers and vendors that were on schedule to be ready that will be the ones being punished.

That’s the conclusion from Ben Quirk, CEO at provider consultancy Quirk Healthcare Solutions in Delray Beach, Fla. The organizations that bit the bullet and spent the time and money now don’t know when ICD-10 becomes real. But many software systems during the next year will get an upgrade and every system in an organization that already has been tested for ICD-10 compliance and is subsequently updated will need to be tested again.

Further, the new compliance delay isn’t going to spur those who have not been proactive in achieving ICD-10 compliance to spend the next year getting there, Quirk worries. Many organizations didn’t do a lot to get ready because they believed the compliance date wasn’t real and turned out to be right, or were waiting for others to find and figure out the kinks. And another delayed deadline that doesn’t even have a definitive date isn’t going to spur readiness activity, he adds. “It’s in everyone’s best interest to procrastinate.”

That said, a delay isn’t all bad, Quirk believes. Having ICD-10 go live in 2014 with a multitude of other major regulatory issues facing stakeholders at the same time was a bad idea anyway. Providers and payers already are overwhelmed and fatigued.

For providers who are ready for ICD-10 or soon will be, consultancies and claims clearinghouses are advising that they start coding in ICD-10 but remain billing in ICD-9. Coders, physicians and others can more quickly become proficient with the coding set and remain so, while organizations can use the more granular data from ICD-10 to enhance analytics initiatives. Organizations also doing ICD-10 before the new go-live date will have an easier time figuring out problems when the inevitable glitches come at go-live time, Quirk says.

A story in the June issue of Health Data Management will examine what happens next as the industry faces another delay in transitioning to ICD-10.

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