CMS Says it Will ‘Re-examine’ ICD-10 Timeline

Editor's Note: This blog was posted before HHS announced they would delay implementation of ICD-10 to a date to be announced.

Physicians got news they loved on Valentine’s Day when CMS’ acting administrator Marilyn Tavenner announced the agency planned to “re-examine” the ICD-10 transition timeframe. However, industry insiders caution that practices should still prepare for the worst. 

At the American Medical Association Advocacy Conference in Washington, D.C., Tavenner told reporters CMS will take a second look at how realistic the timeframe is through a rulemaking process, though she stopped short of saying when the rulemaking process would begin. Currently, the date for fully implementing ICD-10 is Oct. 13. 2013.

"There’s concern that folks cannot get their work done around meaningful use, their work around ICD-10 implementation and be ready for exchanges," Tavenner said according to Modern Healthcare. "So we’re trying to listen to that and be responsive."

It’s no surprise the news comes as a bit of relief to physicians: The North Carolina Medical Society (@NCMedSoc) noted via Twitter that “docs cheered” as Tavenner made her announcement, as physician advocacy groups have been pushing for a delay.

When asked whether he was pleased with the news of the potential ICD-10 pushback, physician Stephen Rockower of Capitol Orthopaedics & Rehabilitation, LLC, of North Bethesda, Md., told Physicians Practice the agency should push it back even further, to 2020 or later.

“The added complexity of ICD-10 is very stressful to physicians who are already struggling to adapt to electronic prescribing, EHR's, new hospital system EHRS, etc.,” said Rockower via e-mail. “This is a very welcome thought to not have to deal with another MAJOR transition on top of all the other transitions we are struggling with. I suppose if I were employed by some large organization with billers and coders it wouldn't be so hard, but many docs in private practice are struggling to keep up.”

Kent Moore, manager of healthcare financing and delivery systems for the American Academy of Family Physicians, said the news of an ICD-10 timeframe adjustment is potentially good news, but it should be taken “with a grain of salt.”

“As far as what practices should do, to the extent CMS hasn’t put anything in writing, practices should continue to plan as if it will be implemented on Oct. 13, 2013,” Moore told Physicians Practice. “My advice to members would be to keep on keepin’ on.”

However, a few insiders have noted that Tavenner announced the supposed timeframe re-examination at an event put on by the American Medical Association, which has vociferously campaigned over the last several months for an extension of the deadline. There’s also - as Government Health IT writer Tom Sullivan noted - some politics that could have influenced what Tavenner stated.

“Tavenner, as acting administrator, is currently vying for the official appointment that her predecessor Donald Berwick, MD somewhat contentiously did not receive,” Sullivan wrote, noting that in November, AMA President Peter Carmel supported President Obama’s nomination of Tavenner for CMS’ highest post.

In his editorial, Sullivan quoted Chris Chute, a physician who spearheads the Mayo Clinic’s bioinformatics division and chairs the WHO’s ICD-11 Revision Steering Group, as saying “we’re all way too far down this pike for somebody, anybody, even the government to say ‘Oh, we were just kidding, let’s stop this foolishness and skip to the next rev.’”

The American Medical Association, however, appeared to embrace the news warmly.

"The AMA appreciates that Ms. Tavenner and the administration have heard our concerns and have recognized the significant challenges and burdens ICD-10 implementation will create on the practice of medicine, and that they are committed to reviewing the pace of implementation,” AMA President-elect Jeremy A. Lazarus said in a statement. “The AMA welcomes the opportunity to discuss ICD-10 implementation, along with many overlapping regulatory requirements that are burdening physician practices."

The deadline for the first step toward ICD-10 adoption - switching over to HIPAA 5010 - passed on Jan. 1, and many practices are either struggling to catch up or finding delays in getting their claims paid because they haven’t caught up, even though CMS delayed enforcement of 5010 until March 31.