Despite claims by the Centers for Medicare and Medicaid Services that the October 1, 2014 deadline for the final transition to ICD-10 was firm, President Obama has signed a new law that will push ICD-10 back until at least October 2015.

H.R. 4302, “Protecting Access to Medicare Act of 2014”, is primarily the latest in a series of patches to Medicare’s sustainable growth rate; however, Section 212 of the bill prohibits the Secretary of Health and Human Services from replacing the current coding standard, ICD-9, with the new ICD-10 any time before October 1, 2015.

The delay has caused significant frustration and may compound difficulties for providers racing to be ICD-10 compliant. Providers at various stages of preparation for ICD-10 will have to maintain both their ICD-10 systems and their current ICD-9 systems until the switch takes place; in addition, many providers who are prepared to begin training for ICD-10 will have to postpone their efforts until a new deadline is announced.

Because the ICD-10 mandate is unfunded, the cost of preparation has fallen to providers who may suffer financially due to a delay. There is also little indication that payers are prepared for billing changes that will take place with ICD-10. At the same time, however, providers who are not as close to full ICD-10 implementation will have at least an additional year to upgrade technology, train their employees, and update their procedures. For payers, the delay will provide additional opportunities for critical end-to-end systems tests.

Proponents of ICD-10 argue that the new system will allow for more accurate coding of a variety of medical conditions, which will not only improve the quality of care but will also streamline billing processes by reducing requests for additional documentation. Health information management professionals recommend that providers stay on track for complete ICD-10 preparation, including a complete shift to ICD-10 coding with translations to ICD-9 until the standard is changed.

ICD-10 may also have a significant impact on healthcare vendors. Medical billing and coding agencies stand to benefit from providers choosing to outsource coding in advance of changing standards, yet all vendors may face longer waits for payment from facilities struggling to meet increasing financial demands.

We will continue to monitor updates to the ICD-10 transition and report on them as they come.

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