Thursday, March 27, 2014

Are Legislators Suffering from R41.9?

In terms of the blogosphere, I've been severely slacking for the last several months. In terms of ICD-10 preparation, I would argue I've done my fair share. As an AHIMA-Approved ICD-10-CM/PCS trainer for nearly 5 years, AHIMA ICD-10 Ambassador, and a senior consultant specializing in ICD-10 education, I've spent much of the three years with my current employer writing ICD-10 web-based and instructor-led training, coding cases using the ICD-10 code sets, and spending countless hours face-to-face with coders across the country conducting basic, intermediate, and advanced ICD-10-CM and ICD-10-PCS training. For three years I chaired Colorado's ICD-10 Task Force, which has worked hard to raise awareness and push implementation efforts forward. 

I've been in the coding industry for 19 years and we've been talking about ICD-10 for my entire career. I remember where I was when the proposed rule for ICD-10 was released and who told me. It was that big of a deal. I remember reading the final rule with elation. I remember ICD-10 being held just after Obama took office because the final rule was released in the last month of the Bush's administration. That delay was short-lived. And, of course, I can still feel the utter frustration I felt the day CMS announced that ICD-10 would be delayed until October 1, 2014. 

And now the fate of ICD-10 hangs in the balance. Again. For crying out loud, US Government, can't we just move on?

If you haven't heard, some language was slipped into House bill 4302 late Tuesday night that would delay ICD-10 for another year. And this morning, the bill passed. Now it's on to the Senate. 

I can only believe that the reason this passed is because our legislators are suffering from R41.9, Unspecified symptoms and signs involving cognitive functions and awareness.  They just don't know what they don't know. 

I'm just not buying the excuse that we can't be ready for ICD-10 in 6 months, even after we've been given a one-year delay already. I've been getting ready for several years, my company has been getting ready for several years, and providers and insurers have been padding their budgets for ICD-10 prep over the last 2 years. I've never seen hospitals buy into IT and training initiatives like they have for ICD-10. And I just don't think postponing ICD-10 again because some providers aren't ready because they didn't think it would really be implemented is a viable reason for a delay. 

To be fair, this bill isn't really about ICD-10. It's about the sustainable growth rate for physicians that they are trying to address before a 24% pay cut for physicians goes into effect on April 1.  The last payment fix for them expires at the end of the month. However, I am bewildered as to how 7 lines of text calling for a one-year delay on ICD-10 managed to make its way into this bill. I am also bewildered as to how a bill that was released 24 hours before it was sent to vote actually passed. Did our congressmen and congresswomen really read the whole bill? And by "read," I mean "read for comprehension." I can only hope that the bill gets killed in the senate. Seriously, the government can't keep leading us on like this!  And more importantly, how will we, as an industry, get enough credibility to ever implement ICD-10 if we have another delay?  If we delay now, we lose all momentum (and dollars) spent by the parties who actually thought the government was serious about ICD-10. 

Here's what you can do: become informed and get your senators informed. The bill claims it will save more than $1 billion over the next 10 years. But what no one is telling them is that those 7 lines that address the ICD-10 delay are projected to cost between $1 billion and $6.6 billion by delaying ICD-10 by one year. And that is only 10-30% of the money that has already been spent by the healthcare industry so far. Are we really willing to throw all that money away when our healthcare industry is already under too much scrutiny for spending?

Go to and see how you can contact your senators by phone or email.  You don't need to be an AHIMA member to do this and you can even read more information about why the language to delay ICD-10 implementation should be removed. Please act today and share this information with your fellow professionals so they can respond too. 

Now if you'll excuse me, I have some emails to write and phone calls to make...