Get the Rundown on ICD-10 Legislation With This Quick Roundup

Fri, Jun 12, 2015 --

ICD-10

Discover which of these three bills has the highest likelihood of being enacted.

With no mention of an ICD-10 delay in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), most practices have taken the view that ICD-10 is coming as planned on October 1, and they need to be ready.

But you may have heard there are still a few holdouts hoping to stop or at least take some of the bite out of the transition to the new code set. Here are the key points to know about three bills under consideration that relate to ICD-10.

US Congress, US Capitol Building, legislation

H.R. 2126: Just Say No to ICD-10

On April 30, 2015, Rep. Ted Poe (R-TX-2) introduced H.R. 2126, the Cutting Costly Codes Act of 2015.

The gist: The bill would stop the switch from ICD-9 to ICD-10.

More details: The bill does the following:

  • Instructs the Department of Health and Human Services (HHS) that it cannot implement, administer, or enforce regulations that put ICD-10 in the place of ICD-9
  • Requires the Government Accountability Office to advise specific ways to make any transition away from ICD-9 easier on healthcare providers.

Did you know? AMA officials have thrown support behind this bill. A statement sent to Rep. Poe declares, “The AMA strongly supports this legislation and continues to seek repeal of ICD-10.”

Current status: After the House referred the bill to the Energy and Commerce committee and Ways and Means committee, Energy and Commerce referred the bill to the Subcommittee on Health.

Prognosis: As of June 11, the prognosis from govtrack.us for this bill showed a 1 percent chance of getting past committee and 0 percent chance of being enacted.

H.R. 2247: Keep Consequences of ICD-10 Mistakes Minimal

On May 12, 2015, Rep. Diane Black (R-TN-6) introduced H.R. 2247, the Increasing Clarity for Doctors by Transitioning Effectively Now (ICD-TEN) Act.

The gist: The bill would create a transition period with ICD-10 testing to be sure Medicare’s claims processing for ICD-10 works.

More details: The bill does the following:

  • Instructs HHS to implement, administer, and enforce regulations that put ICD-10 in the place of ICD-9
  • Requires testing of Medicare’s claims processing for ICD-10
  • Obliges the Secretary to inform Congress whether the system is “fully functioning” and to provide steps to get it fully functional if it’s not
  • Forbids denying claims based on unspecified or incorrect ICD-10

Did you know? AHIMA officials have indicated they don’t see a need for this testing period considering all the work CMS has already completed or has in progress.

Current status: The House referred the bill to the Energy and Commerce committee and Ways and Means committee.

Prognosis: As of June 11, the prognosis from govtrack.us for this bill showed a 5 percent chance of getting past committee and a 1 percent chance of being enacted.

H.R. 2652: Give Providers a Grace Period

On June 4, 2015, Rep. Gary Palmer (R-AL-6) introduced H.R. 2652, the Protecting Patients and Physicians Against Coding Act of 2015.

The gist: The bill would create a two-year grace period during which CMS would not be able to deny claims due to ICD-10 transition related mistakes.

More details: The bill does the following:

  • Requires the HHS Secretary to create a two-year grace period that would mean no penalties for transition-related “errors, mistakes, and malfunctions”
  • Instructs the Secretary to assist providers during the grace period with the switch to ICD-10
  • Requires Government Accountability Office studies on the transition’s effect on healthcare providers in general and in rural areas in particular as well as on how effective the Secretary’s supporting programs are followed by a report by April 1, 2016, with recommendations.

Did you know? AHIMA officials have indicated they are opposed to this bill as it creates the potential for inaccurate coding and possibly even fraud, makes the claims data useless for other purposes like health policy decisions, and ignores the success of end-to-end testing CMS already performed. The AMA has published support for a two-year grace period indicating it will allow providers to focus on patients while switching to the larger code set and help prevent expected payment disruptions.

Current status: The House referred the bill to the Energy and Commerce committee and Ways and Means committee.

Prognosis: As of June 11, the prognosis from govtrack.us for this bill showed a 3 percent chance of getting past committee and a 1 percent chance of being enacted.

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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