Lawmakers, MGMA Seek ICD-10 Transition Period
The Medical Group Management Association is supporting another effort in Congress to enable ICD-9 or ICD-10 coding for six months following the ICD-10 compliance date on October 1.
The Medical Group Management Association is supporting another effort in Congress to enable ICD-9 or ICD-10 coding for six months following the ICD-10 compliance date on October 1.
Reps. Marsha Blackburn (R-Tenn.) and Tom Price, M.D. (R-Ga.) introduced H.R. 3018, which was referred to the House Ways & Means and Energy & Commerce Committees.
Under the bill, the Department of Health and Human Services would implement a transition period during which claims and related transactions otherwise payable (or processed) by public and private payers shall continue to be processed and paid, as applicable, if submitted with ICD-9 codes. The bill also would require within 90 days of enactment that HHS submit a report to Congress assessing the impact of ICD-10 on providers and individuals.
Several bills that would impose a transition period for ICD-10 have been introduced and not enacted, and time is short for action on this legislation with only 17 session days left before the compliance data. However, bills sometimes dont have to be enacted to change policy as lawmakers and stakeholders put pressure on regulators to be more flexible, notes Robert Tennant, director of HIT policy at MGMA. Theres various ways to get to the end zone.
The Centers for Medicare and Medicaid Services, for instance, recently made several ICD-10 policy concessions in a deal with the American Medical Association that cover the Medicare program. Now, the lawmakers and MGMA seek more flexibility.
Also See: New CMS Policies Aid Physician ICD-10 Compliance
MGMAs big worry is that large numbers of physicians through no fault of their own wont be ready for ICD-10 because they have not received software upgrades in a timely manner and may have no way come October to submit ICD-10 claims, or they have been unable to adequately test with insurers.
In addition, a survey with close to 600 respondent practices and weighed to MGMA members found that found that 20 percent of the practices still submit 4010 formatted claims, three years after the ICD-10-supporting 5010 format was introduced. If larger practices never made the change, it is likely that many smaller ones also did not. The 4010 format cannot accommodate an ICD-10 claim, Tennant said.
Further, Tennant notes, compliance with the 5010 transactions set included a 6-month transition period.
Reps. Marsha Blackburn (R-Tenn.) and Tom Price, M.D. (R-Ga.) introduced H.R. 3018, which was referred to the House Ways & Means and Energy & Commerce Committees.
Under the bill, the Department of Health and Human Services would implement a transition period during which claims and related transactions otherwise payable (or processed) by public and private payers shall continue to be processed and paid, as applicable, if submitted with ICD-9 codes. The bill also would require within 90 days of enactment that HHS submit a report to Congress assessing the impact of ICD-10 on providers and individuals.
Several bills that would impose a transition period for ICD-10 have been introduced and not enacted, and time is short for action on this legislation with only 17 session days left before the compliance data. However, bills sometimes dont have to be enacted to change policy as lawmakers and stakeholders put pressure on regulators to be more flexible, notes Robert Tennant, director of HIT policy at MGMA. Theres various ways to get to the end zone.
The Centers for Medicare and Medicaid Services, for instance, recently made several ICD-10 policy concessions in a deal with the American Medical Association that cover the Medicare program. Now, the lawmakers and MGMA seek more flexibility.
Also See: New CMS Policies Aid Physician ICD-10 Compliance
MGMAs big worry is that large numbers of physicians through no fault of their own wont be ready for ICD-10 because they have not received software upgrades in a timely manner and may have no way come October to submit ICD-10 claims, or they have been unable to adequately test with insurers.
In addition, a survey with close to 600 respondent practices and weighed to MGMA members found that found that 20 percent of the practices still submit 4010 formatted claims, three years after the ICD-10-supporting 5010 format was introduced. If larger practices never made the change, it is likely that many smaller ones also did not. The 4010 format cannot accommodate an ICD-10 claim, Tennant said.
Further, Tennant notes, compliance with the 5010 transactions set included a 6-month transition period.
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