Each morning when I wake, I open my eyes and say to myself: This could be the day that the Centers for Medicare and Medicaid Services actually provides guidance to providers, payers and others on the ICD-10 delay. It's a ritual I have been doing since April 1 when President Obama signed the law into effect delaying the ICD-10 implementation deadline by at least a year.

April showers have now brought May flowers but there is still nothing concrete from CMS that the healthcare industry can hang its hat on. Attendees at last week's ICD-10 summit in Washington hosted by the American Health Information Management Association were hoping to get any shred of information from Denise Buenning, acting deputy director of the CMS office of e-health standards and services. Buenning gave the closing presentation at the summit, but the best she could offer the audience was that an announcement would be made in the very near future.

CMS's handling of this whole ICD-10 delay has been troublesome, to say the least. Healthcare stakeholders have been left with the only thing they can do, which is to assume--despite any official announcement from CMS on the matter--that October 1, 2015 is the new ICD-10 deadline. A thin statement on the CMS Web site states that it is "examining the implications of the ICD-10 provision and will provide guidance to providers and stakeholders soon," repeating the legislative language that HHS may not, prior to October 1, 2015, adopt ICD-10 code sets.

Faced with a deafening silence from CMS, industry groups have been urging their constituents to stay calm and carry on. Today, the Workgroup for Electronic Data Interchange held a one-day "emergency industry summit" in Reston, Va., to provide an action plan in response to the ICD-10 delay and to discuss how implementation plans can continue to stay on track. Still, health systems are re-evaluating their implementation and training plans while they await guidance from CMS--without which they are left in a regulatory limbo.

Like other health systems across the country, Phoenix-based Banner Health--with 24 hospitals in seven states--is conducting an impact assessment of the ICD-10 delay to determine the path forward in terms of which organizational activities should stop, start or continue as part of their code conversion. "All the resource time that we're expending on this--the project management and all our team members--has a cost," Linda Martin, IT operations director for Banner Health, told Health Data Management

Charlotte, N.C.-based Premier, a collaborative healthcare alliance of more than 2,900 hospitals and nearly 100,000 other providers, in an April 24 letter to CMS Administrator Marilyn Tavenner 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 to the public. "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.

We all know too well that government agencies move at a snail's pace and that bureaucratic red tape can stand in the way of real progress in getting things accomplished in the public sector. However, the lack of formal guidance on the ICD-10 delay from CMS at this juncture--a month after legislation went into effect--is shameful and completely unfair to providers left to their own devices in planning for the inevitable code transition. When that will actually occur is anyone's guess. One can only hope in the promising morning light of each new day that we will all get word soon from CMS.   

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