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Wednesday, April 1, 2015

No April Fool's Day joke: ICD-10 compliance is now 6 months out

Will it actually happen this time? Powerful constituencies pro and con remain. Plus, the last day of September is the end of the federal fiscal year, always dicey, but this time it will also signal the onset of the 2016 Presidential campaign year. We could be in for another political Clown Car extravaganza in late September, with a lot of legislative items kicked to the curb.

A major uptick in coding granularity. Will all of the EHRs, the health plans, and the clearinghouses be ready with accurate and efficient systems? Will the politicians yet again interfere?

From EHR Intelligence:
Will the SGR Bill Lead to an ICD-10 Implementation Delay?
Author Vera Gruessner | Date March 31, 2015

Many within the healthcare sector question whether the ICD-10 transition will be postponed yet again, but at this point in time, there is no indication from the federal government that an ICD-10 implementation delay will occur.

For instance, on March 26, the House of Representatives passed legislation that establishes a permanent substitute to the Sustainable Growth Rate (SGR) and does not include any reference about an ICD-10 implementation delay.

The Journal of AHIMA reports that the SGR bill — called HR 2, the Medicare Access and CHIP Reauthorization Act — passed in a landslide vote of 392 to 37 and now moves on to the Senate. Staff members from the American Health Information Management Association (AHIMA) do not expect any further additions of an ICD-10 implementation delay to the SGR bill.

If the SGR bill is passed as it stands right now by the Senate and signed into law by President Obama, this would be a major victory for ICD-10 advocates and the healthcare industry as whole. In 2014, an ICD-10 implementation delay was added at the last minute into SGR legislation that set the new deadline to October 1, 2015.

The possibility of an ICD-10 implementation delay was not out of the question when the House of Representatives began the session. Representative Gary Palmer (R-AL) proposed an amendment postponing the ICD-10 transition until October 1, 2017. However, this proposed amendment among others were not added to the legislation...

From The Health Care Blog:
Will Independent Physicians Go Extinct?

Life is tough for physicians in solo and small group practice.  The federally mandated introduction this fall of ICD-10 requires physicians and their staffs to learn a new system of coding diseases.  “Meaningful Use,” another federal program, requires physicians to install and use electronic health records systems, which are complex and expensive.  And PQRS, the Physician Quality Reporting System, is beginning to penalize physicians for failing to report individual data for up to 110 quality measures, such as patient immunizations, each of which takes time to collect and record.

Of course, such requirements are not being imposed solely on solo and small-group physicians.  In many ways, they affect all physicians alike.  Yet the burdens of complying are disproportionately high for small groups, which cannot spread out the costs of purchasing equipment, hiring employees and consultants, and training personnel over so large a number of colleagues.  Hospitals and large medical groups can afford to hire full-time specialists to meet these challenges, but such approaches are not economically feasible for a group that consists of only a few physicians.

Such challenges are not just raining down –  they are pouring down on the heads of physicians...
Interesting. Frequent commenter Dr. Rob observes,
I believe that the oppressive complexity of our system (MU, ICD-10, E/M coding, ACO’s) will force physicians, especially those in primary care, to choose one of two options: join a large group/hospital system that can manage the complexity with a large staff trained to do so, OR leave the system behind. This is evident in the increasing numbers of doctors opting to go the DPC route. That was the choice I was forced to make when I left my old practice, and opted to go DPC. Unless the government does something to simplify things, the exodus of doctors from their system will speed up and create greater problems. We may be at the start of a big crisis in the making.

More to come...

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