by Pamela J. Haney, MS, RHIA, CCS, CIC, COC
Director of Training and Education for Libman Education
On February 11, 2015, the U.S. House Energy & Commerce Committee, Subcommittee on Health, chaired by Rep. Joe Pitts (R-PA) convened to hear testimony on the feasibility of implementing ICD-10 on October 1, 2015. Most, though not all, of the panelists provided compelling arguments in support of ICD-10 implementation for 2015.
While there was wide-spread agreement that we need to move ahead with ICD-10, opinions varied on how that should happen. The impact of uncertainty in the implementation date and concerns about expending additional resources with another potential delay were repeated by several speakers.
Committee members questioned the readiness of CMS to process ICD-10 codes. CMS was identified as a “weak link” in claims processing, citing the rollout of Obamacare and the Healthcare.gov website issues. Another committee member questioned what contingency plan is available if CMS fails to accurately process claims after October 1, 2015.
Dr. Edwin Burke, part of a small provider office in Missouri, indicated that “teamwork + leadership = success” in implementing ICD-10 in a provider setting. Healthcare is moving quickly and “delaying ICD-10 is not blinking but closing our eyes.”
Robert Averill, Director of Public Policy from 3M, described ICD-9 as from a bygone era. He stated that we need to focus on value and quality and not volume.
AHIMA’s Sue Bowman described a growing demand for complete and accurate documentation that is required whether we use ICD-9 or ICD-10 for improved data analysis, quality outcomes and research support. We have had 6 years to prepare and a delay will only prolong readiness.
Kristi Matus. Chief Financial and Administrative Officer for Athena Health, described ICD-10 as providing the basis for value-based delivery model for improved outcomes and decreased costs. She stated the continue delays in ICD-10 are driving up costs and creating fear. She asked the committee to either “pull the trigger or pull the plug” for ICD-10 implementation.
Dr. William Jefferson Terry, a urologist representing the American Urological Association, estimated there will be a 3 to 4% increase in provider time for each patient to document completely for ICD-10. He requested the committee to consider a dual transition for the first year that would allow physicians to report in either ICD-9 or ICD-10.
Dr. John Hughes, a medical researcher and professor from Yale University, urged the committee to consider ICD-10 implementation to provide usefulness and validity to support research activities as ICD-9 fails to provide the specificity needed.
Representative Ellmers, a nurse married to a surgeon, expressed concerns about implementation costs especially for rural providers. Mr. Averill responded that several surveys of small practices (6 or less providers) revealed an average cost of $8,000 for ICD-10 implementation. He also indicated that there are several free and low cost resources available to prepare for ICD-10.
It will be interesting to review the committee’s final recommendation after review of the testimony and documents submitted by interested parties.
Pamela J. Haney, MS, RHIA, CCS, CIC, COC, is an experienced educator and an AHIMA approved ICD-10 trainer with over thirty years experience as a Director of HIM and Coding Services. She was a beta tester for the AAPC CIC exam and one of the first to receive the CIC certification. She is a recipient of the 2013 AHIMA Triumph Award in the Mentor category.