HHS proposes one-year delay of ICD-10 deadline

posted 04.12.12

The Department of Health and Human Services announced Monday, April 9, their intention to delay the compliance date for the International Classification of Diseases, 10th Edition, the code set for outpatient diagnosis coding. The new deadline is Oct. 1, 2014.

CMS Administrator Marilyn Tavenner told reporters in February that CMS would “re-examine the timeframe” for ICD-10, though neither she nor HHS Secretary Kathleen Sebelius specified the actual date. The proposed rule delays the deadline by one year and adds a National Provider Identifier requirement.

“While the delay may give you more time to prepare, it most certainly does not mean that you can postpone this work; it just means that if you start now, you might actually be ready by the new deadline,” wrote Cindy Hughes, C.P.C., in a Family Practice Management article. “The changes required in your workflow, your technology, and your thinking are massive.”

The ICD-10 code set includes an additional 55,000 codes than ICD-9, and Hughes explained in FPM the rationale for its implementation. “It is coming because the inpatient procedure portion of ICD-9 has run out of room for code expansion; because a move from fee-for-service payment to value-based purchasing of health care requires better identification of the complexity of conditions that are treated and managed; and because ICD-10 diagnosis codes convey more detailed information that may reduce delays in claims processing. Researchers will no doubt gain from the added specificity as well, but this is not the driving force of the transition as some have speculated.”

HHS cited in the April press release that the move will allow for “greater specificity” of diagnosis and preventive services that will lead to “improved accuracy in reimbursement for medical services, fraud detection, and historical claims and diagnosis analysis for the health care system.”

Physician advocacy organizations, including AAFP, expressed concerns with the ability of physicians to meet the 2013 deadline as practices must first comply with HIPAA 5010 standards for electronic health care transactions, and that was likely one factor leading to the delay. For more information on how to move forward with your ICD-10 preparations, read the FPM article, “ICD-10: What You Need to Know Now,” or visit TAFP’s practice resources on billing and coding at www.tafp.org/practice-resources/billing-coding.