CMS is standing firm on its 2014 ICD-10 implementation, while also dealing with the effects of sequestration and the challenge of reaching smaller practices.
Fully confident that there will be no further delays in the transition from ICD-9 to ICD-10, CMS admits that there have been recent setbacks, from the effect of sequestration to difficulty reaching smaller medical practices.
In 2012, CMS announced it was delaying the planned implementation of the ICD-10 code set one year from its original target of October 1, 2013, in the face of concerns from various stakeholders to meet compliance in time. But now 17 months away from making the switch, Denise Buenning, deputy director for CMS' Office of E-Health Standards and Services, says everything is on track.
"There is absolutely no reason to believe that the deadline will move again," Buenning told attendees of the 2013 ICD-10-CM/PCS and Computer-Assisted Coding (CAC) Summit held in Baltimore on April 24 sponsored by the American Health Information Management Association (AHIMA). She added that the healthcare industry has invested billions in the transition, that the benefits recognized are very real, and that another delay or skipping right to ICD-11 would be "problematic."
"We are dedicated to see this go in 2014 and I've heard nothing to say otherwise," she said.
CMS is also viewing the ICD-10 transition as part of its larger eHealth initiatives, including its EHR Incentive Program and Physician Quality Reporting System, working in unison toward the goal of better care at lower costs.
"The future of eHealth is really at a precipice," Buenning said. "Alignment is key … so this is not ICD-10 as a standalone. It is how we treated it at CMS for years … but now, it is part of an exchange of robust healthcare information."
She added, "There are lots of ICD-10 opportunities, but unless providers put them to use … they are no good."
Among those opportunities Buenning discussed were improved claims payment accuracy and efficiency, better quality measurement through improved identification of patient populations, and enhanced fraud, waste, and abuse prevention and detection.
"There are so many different reasons we need ICD-10," Buenning said. "[Reasons] I think answer critics who say we don't need ICD-10."
Buenning said she "has fewer sleepless nights" as CMS and its partners get closer to implementation, but one source of "restlessness" still comes from reaching the small provider community.
"Those one- and two-doctor practices who if they don't know about ICD-10 at this point - that makes me concerned," she said. "We are getting feet on the ground to reach them and give technical assistance. For them, it may not seem like a big priority, but it should be."
One recent obstacle in that outreach, and overall efforts by CMS, has been funding cuts due to sequestration. Like all federal agencies, Buenning said her office was affected and it is maximizing and diverting other resources to ensure a smooth transition for all providers.
"We can't do this alone," she said, urging all stakeholders to play a role in moving toward ICD-10. "We had limited funds to begin with as this was an unfunded mandate and sequestration did take another bite. But this is about working smarter, not harder."