CMS extends ICD-10 implementation until late 2014

Implementation of the International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), has been delayed until October 1, 2014, according to new rules published in the Federal Register.

The extension was granted to offer healthcare providers more time to implement the more detailed system, according to the Centers for Medicare and Medicaid Services (CMS).

"Some provider groups have expressed strong concern about their ability to meet the October 1, 2013, compliance date and the serious claims payment issues that might then ensue. Some providers' concerns about being able to meet the ICD-10 compliance date are based, in part, on difficulties they have had meeting [the U.S. Department of Health and Human Services'] compliance deadline for the adopted Associated Standard Committee's (ASC's) X12 Version 5010 standards (Version 5010) for electronic healthcare transactions," CMS says in the rule.

"We believe the change in the compliance date for ICD-10, as proposed in this rule, would give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition by all industry segments," CMS says.

ICD-10 is the latest version of the classification and coding system of diseases for physicians and other healthcare entities. It expands the diagnoses and procedure codes outlined in ICD-9 from 17,000 to 155,000.

Medical Economics reported on a survey in mid-July from HealthEdge, which found that only 61% of payers were ready to implement ICD-10. Preparedness continues to concern the Medical Group Management Association–American College of Medical Practice Executives (MGMA-ACMPE).

"We are not confident that critical trading partners, including Medicare and state Medicaid plans, will be ready in time to conduct testing well in advance of the October 2014 compliance date," says Susan Turney, MD, MS, FACP, FACMPE, president and chief executive officer (CEO) of MGMA-ACMPE. The organization is asking CMS to "significantly escalate its implementation efforts by pilot testing ICD-10; ensuring health plan, clearinghouse, and vendor readiness; and developing comprehensive educational resources."

Despite the delays, CMS contends the change is needed, noting that "covered healthcare providers are frustrated by various problems associated with the lack of a standard identifier, such as improper routing of transactions; rejected transactions due to insurance identification errors; difficulty in determining patient eligibility; and challenges resulting from errors in identifying the correct health plan during claims processing."

MGMA-ACMPE maintains, however, that "CMS missed a significant administrative simplification opportunity to create true claims revenue cycle transparency with the health plan identifier rule. By not requiring health plans to enumerate at a more granular level, physicians will continue to face the burden of manually identifying these entities."

The American Health Information Management Association (AHIMA), however, says it is "reassured" by news of the 2014 deadline.

“ICD-10-CM/PCS implementation is inevitable, but today’s news gives the healthcare community the certainty and clarity it needs to move forward with implementation, testing, and training,” says AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE. “We realize that a few are still apprehensive about the implementation process, and that is why AHIMA remains committed to assisting the healthcare community with its transition to a new code set that will lead to improved patient care and reduced costs.”

Go back to current issue of eConsult