Insight: It might be time to start planning for an ICD-10 delay
Another delay is unlikely but not unthinkable.
No, I'm not saying another delay of ICD-10 implementation is imminent. But this is the time to worry.
That's because Medicare's sustainable growth rate (SGR) is set to kick in April 1 unless Congress repeals it or delays it.
That is almost what happened last year when an Oct. 1, 2015, ICD-10 compliance deadline was slipped into an SGR delay. The American Medical Association (AMA) had lobbied hard for an SGR repeal. But at the end of the month, politicians couldn't agree on where to get the funds to replace the SGR. So they killed the bill and enacted a one-year delay to work on a new repeal. And ICD-10 was delayed a year too.
This year, there's no SGR repeal on the table. So it looks like another SGR delay will be needed to preserve Medicare reimbursement levels by March 31.
[Also: 6 tips for preparing for ICD-10]
That doesn't mean another ICD-10 delay is about to be inserted in the legislation. The U.S. House Energy & Commerce Subcommittee on Health hearing on ICD-10 Implementation last month showed a lot of support for ICD-10 implementation.
So another delay is unlikely but not unthinkable.
Know what else is possible? A dual coding contingency plan.
[Also: ICD-10 passes end-to-end testing]
Yes, the AMA is arguing that the Centers for Medicare and Medicaid Services (CMS) is not ready so there needs to be a plan B. That in itself doesn't worry me. I don't believe the AMA has that much political clout.
But the idea of allowing medical practices the option of sending medical claims with either ICD-9 codes or ICD-10 codes had some traction among politicians at last month's hearing. Another HealthCare.gov misstep may persuade them to do a soft launch of ICD-10 coding on Oct. 1.
This would be a good time for American Health Information Management Association (AHIMA) to explain why dual coding won't work in terms a politician can understand.
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