What are providers, payers, suppliers and clearinghouses doing in the wake of the unexpected announcement by the Department of Health & Human Services (HHS) that it plans to delay implementation of the ICD-10 system?
In general, HIMSS conference attendees (vendors, payers, and providers) are very disappointed with the potential delay and are waiting to see what the HHS final rule will say. They also say they will continue to move forward with plans to implement I-10. That was the consensus this morning among panelists who were calling in from the 2012 Annual HIMSS Conference and Exhibit in Las Vegas during Talk-Ten-Tuesday, the ICD-10monitor podcast.
Chris Powell, president of Precyse, whose organization sponsored the daylong ICD-10 symposium held yesterday at HIMSS, shared the sentiment expressed by the other panelists and also emphasized the importance of continuing to improve clinical documentation whether it's for ICD-9 or ICD-10. Rhonda Taller, the government affairs specialist in the healthcare policy and reimbursement group for Siemen’s Healthcare, who spoke on yesterday’s vendor panel during the symposium, outlined the legislative process that CMS will embark upon. Bonnie Cassidy, vice president of health information management (HIM) at QuadraMed, speaks for many when she says, “Hopefully, we won’t have a long delay.”
Like others, she says that QuadraMed is moving forward with its plans, which include a dual-coding system that supports both ICD-9 and ICD-10 code sets. Through the use of the system, users can test their ICD-10 interface transactions in combination with live encounters while also using ICD-9 codes.
Another panelist—Mark Morsch, vice president of technology for OptumInsight— also agrees that progress is key. “No providers want to slow this down because they recognize the benefits” of overall process improvements, he says. Improvements include achieving more integrity in the revenue cycle, accurate coding, and better documentation. “Process improvement is fundamental for I-10,” Morsch says.
At the end of the Feb. 21 webcast, listeners posed several questions to panelists:
Question: If ICD-10 goes forward, which ambulatory surgeries will not be required to use it? Answer: Anyone who does diagnosis coding, which is mainly outpatient providers and physicians, must use I-10 diagnoses. Inpatient hospitals will use the ICD-10-PCS for procedure coding.
Question: With the delay, how can we maintain the commitment of our hospital executives? Answer: Focus on what has been achieved already, such as process improvements, and the significant financial commitment that’s been made already.
Question: What is your opinion of skipping over I-10 and going straight to I-11? Answer: It would take years, probably no earlier than 2020, before the United States could implement I-11. For ICD-10, it took eight years to get ready. Although there’s some chatter in the media about skipping over ICD-10, in truth a transition from ICD-10 to ICD-11 would be optimal.
Question: What happens to 5010 implementation now? Enforcement period is up at the end of March with compliance set for April 1. There’s no indication that the Centers for Medicare & Medicaid Services (CMS) intend to push back further.
And probably the most important question of all: How long will it take before we know what HHS plans to do? No one knows the answer to this question yet. HHS must issue a proposed rule in the Federal Register, which offers the public an opportunity to comment with a specific time period (such as 30 or 60 days). Before it issues a final rule, HHS will review public comments. The final rule, which will include public comments and HHS responses, will be published after that, and a new compliance date will be set.
Tomorrow: More live coverage from the HIMSS conference
About the Author:
Janis Oppelt is an editor with MedLearn, Inc., a Panacea Healthcare Solutions company, St. Paul, MN.
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