Our Response to the ICD-10 Deadline Extension to 2015

Surprisingly, things can move fast in Washington, D.C. On Thursday, March 27, the House of Representatives passed bill H.R. 4302 (Protecting Access to Medicare)—known as the ‘Doc Fix’ bill—by voice vote. This bill’s main provision is to adjust the sustainable growth rate (SGR) for Medicare payments, which states how much physicians get paid for services. The deadline for SGR was March 31, meaning if the bill had not been approved, a 24% reduction in Medicare payments to physicians would’ve taken affect.

Yesterday, March 31, the Senate also passed the bill, and President Barack Obama signed H.R. 4302 into law on April 1. Within the 100-plus page bill is an added, last-minute provision to delay the implementation of ICD-10 until October 1, 2015. While the ICD-10 transition has been delayed several times already, this move adds a full calendar year to the deadline before the transition.

The move to delay ICD-10 will come with benefits and drawbacks to the industry. DocuTAP, and many other healthcare vendors, have already been impacted financially by ICD-10 preparation needs. Providers have also started to feel these costs passed down. However, these costs are minor compared to the impact ICD-10 could have caused if it had been implemented before payers are ready.

While the average ICD-10 prep cost to ambulatory providers is estimated to be in the thousands of dollars, the cost providers would have to pay without prepared payers could have been much greater. This is why the Centers for Medicare and Medicaid Services (CMS) had encouraged providers to have a cash backup on hand. Projections ranged from $50,000 to $150,000 to ensure practice solvency.

Many healthcare vendors, including DocuTAP, are prepared for ICD-10, but payers were—and are—the main concern regarding ICD-10 implementation in the United States. DocuTAP has been advised that approximately 30% of payers were ready for ICD-10. While it’s true the majority of the world uses ICD-10 in a single payer system, the United States has thousands of payers, making ICD-10 adoption a more complex undertaking.

In reality, the ICD-10 delay doesn’t change DocuTAP’s direction. Our company will continue to prepare for the transition to ICD-10, and will move forward with plans to release ICD-10 functionality within our software on our original timetable. Our hope is that everyone involved will continue working toward being completely prepared well before the new deadline in 2015.