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The U.S. Department of Health and Human Services earlier this month granted a two-year deadline extension to 2013 for the transition from ICD-9 codes to the greatly expanded ICD-10 codes.
Citing an outpouring of demand for more time, the U.S. Department of Health and Human Services earlier this month granted a two-year deadline extension to 2013 for the transition from ICD-9 codes to the greatly expanded ICD-10 codes.
In August last year, HHS set an October 1, 2011, deadline for the transition to ICD-10, which contains 155,000 codes compared to ICD-9 which has 17,000. For example, ICD-9 has only one code for angioplasty while ICD-10 provides 1,170 coded descriptions, even down to the location of the blockage and the device used for each patient, according to HHS.
Since then, regulators received more than 3,000 public comments, with a majority asking for a delay in the compliance dates citing implementation costs, the need to train healthcare personnel, and to ensure ample time for testing.
But just because providers have another two years to prepare doesn’t mean they can bury their heads in the sand, says Edward Gaines, the Greensboro, North Carolina-based chief compliance officer for CBIZ Medical Management Professionals, a provider of physician billing services and practice management consulting.
“[HHS] is like a drunken sailor but the grog, this time, is data,” he says. “Having this new data has a lot of significant health implications, but it’s hugely expensive for providers.”
Gaines cites a study by Reistertown, Maryland-based research firm, Nachimson Advisors LLC, which reported the ICD-10 upgrade would cost a practice with three physicians about $83,290, and a practice of 10 physicians $285,195 to upgrade.
“It’s a classic unfunded mandate,” he says. “A lot of providers are looking at this and saying either ‘I’m out, or going to be out soon.’ They throw up their hands.”
Robert Fischer, MD, a solo gynecologist in Wichita Falls, Texas, who is 56-years-old, anticipates he will be retired by the time ICD-10 becomes mandatory.
“The last time we updated with the NPI (National Provider Identity number), it was an extremely expensive update – where’s the benefit?” says Fischer, who received a notice about the deadline extension from the Texas Medical Society and posted it on the physician online social network site, Sermo.com.
If he planned to stay open in time for ICD-10, Fischer, who does his own coding, expects he would ask his billing software company if it is capable of handling the influx of more than 138,000 additional codes and inquire if he’ll need to update his computers and operating system. Gaines also recommends contacting vendors to find out how they’re preparing for the changeover.
“Four years will seem like tomorrow when you’re dealing with this,” Gaines says. “We got more time, which is good, but it doesn’t decrease the significance of it at all.”