ICD-10 Delay: Good News or Bad for Physicians?

April 9, 2014

Whether they think it is good or bad news, savvy physicians will use the extra time to prepare their practices for the ICD-10 coding transition wisely.

Like students who've just learned that a difficult test has been unexpectedly postponed, the reaction to Congress' surprise delay of the ICD-10 code set implementation date has been met with mixed reactions. Those who are prepared are frustrated; those who aren't are relieved.

The AMA pushed hard for a delay, yet tied as it was to yet another Medicare sustainable growth rate (SGR) formula patch, it brought less joy than one might have expected. But the mixed reaction is not totally due to the way the delay was packaged. Many large healthcare systems, hospitals, large medical practices, and payers have put a lot of effort and resources into getting ready for the shift from ICD-9 and are finding the delay frustrating. Small practices, on the other hand are relieved. More time is just what they've hoped for.

"We were calling for a delay because the [ICD-10 implementation] was not ready for prime time. Small practices just weren't ready to handle it yet," said Reid Blackwelder, president of the American Academy of Family Physicians, another organization advocating a delay. However, Blackwelder also points out the dangers inherent in yet another postponement: "Our members may believe that ICD-10 will continue to get bumped down the road - just like SGR repeal has. But it will be coming and we will continue to help our members get ready."

Reprieve reaction
Fletcher Lance, vice president and national healthcare leader at consulting firm North Highland, agrees the delay might be something of a mixed blessing even for small practices grateful for the extra time. "Many were using hope as a strategy - and it worked," he said. "This might lead them to think that the same strategy will work again."

However, faith in an ever-receding deadline will only lead to more panic when the deadline comes around again. Even those with a great deal of sympathy for the challenges ICD-10 creates for physicians can see potential problems in what might seem like good news. "Physicians are facing tough times right now, but we need to be realistic," said Maxine Lewis, healthcare consultant and author of "Working With Insurance and Managed Care Plans: A Guide To Getting Paid." "I think it will happen, and another year's delay will just reduce the pressure physicians put on their vendors to change their codes. I'm a physicians' advocate and I don't think this delay is good for physicians."

Next steps
So what's the right strategy? "The smart thing to do," said Lance, "is to take a careful look at where you are [in preparation] and recalibrate." This advice applies no matter how far along you are or how much money you've already spent. "Before doing anything, look at the timeline [to Oct. 1, 2015 at the earliest] and decide how to spread your resources over a bigger amount of time. If you have been training or working with vendors, continue to do that. But don't take this as an excuse to stop preparing," Lance said.

In school, the students who took that unexpected reprieve as an opportunity to make up for lost time, or to continue to bone up, ended up passing the test. Those who saw it as an excuse to take a bit of time off didn't do so well. The same will happen to medical practices. Those who use this extra time wisely will be in much better shape when ICD-10 does come around, whether that turns out to be October 2015 or not.