Congress has delayed implementation of the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) until October 2015, a one-year delay and the latest in a series of deadline pushbacks deemed necessary to allow health care providers and other stakeholders in the U.S. adequate time to implement the enormous code set. President Obama approved the implementation delay as part of HR 4302, the "Protecting Access to Medicare Act of 2014," which he signed into law on April 1, 2014, following passage by the Senate one day earlier.
The bill text relating to the ICD-10 delay reads: "The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD-10 code sets as the standard for code sets under section 1173(c) of the Social Security Act (42 U.S.C. 1320d-2(c)) and section 162.1002 of title 45, Code of Federal Regulations."
As discussed by DC columnist Sam Collins in the Jan. 1, 2014 issue ("Top 5 Billing Issues for 2014"), the ICD-10CM code set is daunting in that it features more than 68,000 codes, each of which is 5-7 characters with an alpha beginning. By comparison, ICD-9CM codes only number approximately 13,000 and are 3-5 numerical digits. While proponents of the ICD-10 assert that the expanded code set will allow for greater specificity of diagnosis, among other benefits, getting practitioners, much less software programs, up to speed represents a significant challenge.
All Health Insurance Portability and Accountability Act (HIPAA) covered entities are required to transition to ICD-10, and adoption of electronic data interchange (EDI) Version 5010 (upgraded standards for electronic transmission of health care transactions) is a prerequisite.
Despite an original implementation date of Oct. 1, 2011, the ICD-10 deadline has now been pushed back multiple times. Is the Oct. 1, 2015 deadline the last – or just the latest? Look for updates as this year winds down.
