How To Tell If ICD-10 Implementation Will Be Delayed Again

While Tuesday’s election was important for many reasons, none of them have a direct impact on the ICD-10 debate.

This is a behind the scenes issue that doesn’t appear in an election speech or advertisement. Thus I don’t know if there is U.S. Representative or Senator who harbors a deep hatred of ICD-9 coding and will not let anything get in the way of ICD-10 implementation Oct. 1.

And it doesn’t matter who controls the U.S. Senate. This is kind of a non-partisan non-issue.

There are some other Capitol Hill events that can affect the ICD-10 timeline.

Protecting Access to Medicare Act of 2014 (PAMA) ends March 31

That means the sustainable growth rate (SGR) will dictate a 24 percent drop in Medicare payments April 1. Whenever this comes, the American Medical Association (AMA) screams, and Congress extends the deadline.

The AMA is likely to try to kill the SGR again. It’s not hard to imagine them sneaking in a provision that kills ICD-10 coding too. After all, AMA President-Elect Steven Stack said he wanted to kill ICD-10 implementation.

Even if the AMA is unsuccessful, there probably will be PAMA II — another short-term SGR delay. And while they’re changing the date on that incredibly unpopular mandate, it will be incredibly easy to change the date on another incredibly unpopular mandate.

We need to pay attention to any discussion of the SGR or possible “doc fix.”

ICD-10 costs

This is really why the AMA and just about every physician really is opposed. Everything else is rhetoric. If Congress finds a way to fund implementation costs for small medical practices and independent physicians, we’re going to be using ICD-10 codes this year.

But money doesn’t grow on the trees on Capitol Hill. Each new program needs to be funded by taking away from another program.

That’s why the SGR still lives. That money it would have generated had to be replaced by another source. And the opposition didn’t think the plan was realistic.

So if someone crafts an ICD-10 Stimulus Act that finds some real money to help the small healthcare providers, they will need to persuade Congress to take the money from somewhere else associated with weak lobbyists.

Any kind of health care funding debate will be a good place to introduce ICD-10 funding.

 AHIMA gets very active

The American Health Information Management Association (AHIMA) needs to do more than sing ICD-10’s praises on social media. If they can put compelling arguments before politicians for ICD-10 implementation more often, ICD-10 coding becomes more than an obscure element in a healthcare bill.

Look for politicians to start talking about controlling waste and fraud. That’s where ICD-10 coding could sneak into some legislative debate. If a politician makes the argument that $X is being wasted because ICD-9 codes do not adequately reveal healthcare waste and fraud, then it’s going to real hard to stop ICD-10 implementation.

There are so many unkowns, we will not be able to predict what will happen to the ICD-10 deadline. But by watching the politics of healthcare carefully, we can get some warning signs

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