ICD-10, the International Classification of Diseases version 10 from the World Health Organization (WHO) is supposed to go into effect in the United States on October 1, 2014 2015.  Today on Twitter, proponents of ICD-10 asked the U.S. Senate not to delay ICD-10 as part of H.R. 4302.  H.R. 4301 is designed primarily to re-adjust  the Sustainable Growth Rate (SGR) for Medicare payments. Section 212,  states that the Department of Health and Human Services (HHS) cannot implement ICD-10 October 1, 2015 or perhaps later.

The final AYE was cast on Monday March 31st at approximately 6:45pm to delay ICD-10 as part of H.R. 4301.

History Repeats Itself

Healthcare.gov, the U.S. Health Insurance Exchange (HIX) went live October 1, 2013 with no real-world testing. Like Healthcare.gov, ICD-10 is going live with much larger financial impact and  limited testing by 500 health care providers who submit claims to Medicaid.  This testing is currently scheduled for July, 2014 and was only agreed to by CMS after pressure from several sources.

Test ICD-10, Instead of Delaying it Entirely

Unfortunately keeping ICD-10 on schedule or delaying it were probably both bad choices.  The reason is that there has been almost no testing of ICD-10 despite its significant impact on the $3 trillion U.S. health care economy.  A better strategy would be to keep October 1, 2014 as a deadline and enforce it for testing, much as health care providers must be tested to prove they use electronic health records for Meaningful Use stimulus funds.  Exemptions from Meaningful use dates are also provided for.  Neither testing or exemptions, even for hardships, are part of the ICD-10 mandate.  ICD-10 CM (the U.S. version of ICD-10 diagnosis codes) was not legislated with the same thoroughness of stimulus funds, exemptions and rigorous testing as Meaningful Use of Electronic Health Records.  ICD-10 has been delayed before and most physicians didn’t use the extra time to prepare, they just put it off.

Now we’ll have to see if the industry uses the extra time to implement ICD-10 wisely.  If this delay is like the last, then history will repeat itself.

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