Conversion to ICD-10 Coding System Delayed Until October 1, 2013

Posted by Jason Greis on January 21, 2009 under Articles | Be the First to Comment |  Print

The Department of Health and Human Services (HHS) issued a final regulation on Jan. 15, 2009 giving health care providers (including LTACHs) and plans two additional years-until October 1, 2013-to adopt the new health care coding system, the International Classification of Diseases, Tenth Revision (ICD-10).  Under a proposed rule issued in August 2008, health care providers would have been required to adopt ICD-10 by October 2011.   This new coding system greatly expands on the ICD-9-CM codes sets, which were developed nearly thirty years ago.  HHS agreed to delay the compliance deadline in order to accommodate the concerns (generally concerns regarding implementation and training costs) of over 3,000 commenters urging that more time is needed for effective industry implementation of the new coding system. 

LTACH and hospital industry organizations, including the Acute Long Term Hospital Association (ALTHA), the American Hospital Association, and the Federation of American Hospitals, have long been in favor of implementing ICD-10, and this further implementation delay is sure to be viewed as an unwelcome development.  The American Health Information Management Association issued a statement expressing regret about the extension of the ICD-10 compliance deadline until 2013.

Along with the ICD-10 rule, HHS issued a related final rule updating standards for electronic health care transactions under the Health Insurance Portability and Accountability Act (HIPAA).  This final rule adopts updated versions of the standards for certain electronic health care transactions, under the authority of HIPAA.   HIPAA “covered entities” such as health plans, health care clearinghouses, and certain health providers must begin using the updated standard on Jan. 1, 2012, although small health plans have an additional year and must comply on Jan. 1, 2013.

According to a fact sheet issued by the Centers for Medicare & Medicaid Services, these two rules will facilitate the nation’s transition to an electronic health care environment.  Under the first regulation setting forth adoption of the ICD-10 system, CMS is adopting the new medical code sets as standards under HIPAA for use in reporting diagnoses and inpatient hospital procedures in health care transactions. By setting an Oct. 1, 2013, compliance date, HHS said, the industry will have nearly five years from the date ICD-10 was first published to implement the new code sets.

According to HHS, adoption of the ICD-10 code sets is expected to support Medicare’s value-based purchasing initiative and anti-fraud and abuse activities by accurately defining services and providing specific diagnosis and treatment information. In addition, HHS said, the expanded code sets will:

• support comprehensive reporting of quality data;
• ensure more accurate payments for new procedures, fewer rejected claims, improved disease management, and harmonization of disease monitoring and reporting worldwide; and
• allow the U.S. to compare its data with international data to track the incidence and spread of disease and treatment outcomes.

Please contact me if you have any questions.

Jason S. Greis 
312.849.8217
jgreis@mcguirewoods.com