There were a lot of announcements and events in 2012 that influenced the ICD-10-CM/PCS transition. But there were three major events that were key in shaping how and when we implement ICD-10 coding.
Here's what happened:
Here's what happened:
The ICD-10 compliance deadline is moved - again
The Department of Health and Human Services (HHS) announced it would consider delaying ICD-10 implementation past the Oct. 1, 2013, deadline. This came after the Centers for Medicare and Medicaid Services (CMS) spent 2011 insisting that the deadline was set in stone. Nothing was going to move it.
The major argument against delay came from large hospitals and healthcare vendors. They said publicly that any delay would signal that CMS wasn't serious about the ICD-10 transition and healthcare organizations might procrastinate further because another delay could be possible.
The American Medical Association (AMA) expressed joy that its concerns about readiness were being taken seriously. It also advocated leapfrogging ICD-10 implementation to ICD-11 implementation.
After a few months of thousands of comments submitted, it announced a new deadline - Oct. 1, 2014. Despite what the really organized healthcare organizations said, this gave everyone a little more breathing room. Small healthcare providers get an extra year to get ready. Some hospitals announced they would stick to the Oct. 1, 2013, deadline and use the extra year for testing. Healthcare payers needed the extra year despite what was claimed publicly. And healthcare vendors got more time to sell their systems and training.
This made 2012 a fun year for bloggers like me. I got to cover an endless amount of debate and speculation. And the delay ensured that this blog got to exist another year.
HIPAA 5010 has a rocky start
First, HHS announced it will give healthcare organizations extra time to get their act together. That ended meaning a six-month enforcement delay. Which wasn't a major factor compared to the reimbursement delays.
What was supposed to be a simple, administrative change resulted in an avalanche of medical claim rejections and reimbursement delays. It took a few months to figure out why so many claims were being rejected and how to properly submit.
There was a good chance these problems persuaded HHS that an ICD-10 compliance delay was necessary. If this simple, administrative change could be so disruptive, then ICD-10 implementation could be a disaster. Giving the healthcare system an extra year to get systems upgraded and test the new medical codes could make a major difference.
HIPAA 5010 taught us a lot about testing that's going to shape how we test ICD-10 use in medical claims.
Obama wins the election and Supreme Court
If President Obama lost the presidential election to Mitt Romney or the Supreme Court decision on the healthcare reform law known as Obamacare, ICD-10-CM/PCS would have become a casualty.
The ICD-10-CM/PCS code set almost didn't survive 2012. Here's what happened:
The ICD-10 compliance deadline is moved - again
The Department of Health and Human Services (HHS) announced it would consider delaying ICD-10 implementation past the Oct. 1, 2013, deadline.
HIPAA 5010 has a rocky start
First, HHS announced it will give healthcare organizations extra time to get their act together. That ended meaning a six-month enforcement delay. Which wasn't a major factor compared to the reimbursement delays.
Obama wins the election and Supreme Court
If President Obama loses the presidential election to Mitt Romney or the Supreme Court decision on the healthcare reform law known as Obamacare, ICD-10-CM/PCS would become a casualty. On the surface, the Patient Protection and Affordable Care Act (PPACA), has nothing to do with ICD-10 implementation. The mandate predates the Obama administration. But the ICD-10-CM/PCS code sets could become collateral damage in political battles.
First, Romney pledged to repeal Obamacare. This wouldn't have affected the ICD-10 mandate. But it wouldn't be a stretch for a Romney administration to see it as an unfunded mandate that placed financial and bureaucratic burdens upon physicians. Republicans can be sympathetic to arguments about upgrade costs and administrative requirements that time away from treating patients.
Of course Romney would want to enact his version of healthcare reform. What that would look like is anyone's guess. But there's a good chance that killing ICD-10 implementation could be a way to woo the AMA to support Romneycare.
It is possible that a Romney-appointed HHS leadership could see ICD-10 coding as a tool for trimming waste and fraud from the healthcare system. Republicans do love fighting waste and fraud because no one wants to be seen as in favor of it.
Second, if the Supreme Court rejects the PPACA, Obama needs to go back to the drawing board. He may need the support of the AMA to create a new reform. And ICD-10 implementation could be a bargaining chip. He might need to scuttle it or offer meaningful use type incentives.
Without a Supreme Court victory, all healthcare initiatives are on the defensive.
Now that Obamacare is alive and well, it's going to need the ICD-10 data to achieve its goals.
If President Obama lost the presidential election to Mitt Romney or the Supreme Court decision on the healthcare reform law known as Obamacare, ICD-10-CM/PCS would have become a casualty.
The ICD-10-CM/PCS code set almost didn't survive 2012. Here's what happened:
The ICD-10 compliance deadline is moved - again
The Department of Health and Human Services (HHS) announced it would consider delaying ICD-10 implementation past the Oct. 1, 2013, deadline.
HIPAA 5010 has a rocky start
First, HHS announced it will give healthcare organizations extra time to get their act together. That ended meaning a six-month enforcement delay. Which wasn't a major factor compared to the reimbursement delays.
Obama wins the election and Supreme Court
If President Obama loses the presidential election to Mitt Romney or the Supreme Court decision on the healthcare reform law known as Obamacare, ICD-10-CM/PCS would become a casualty. On the surface, the Patient Protection and Affordable Care Act (PPACA), has nothing to do with ICD-10 implementation. The mandate predates the Obama administration. But the ICD-10-CM/PCS code sets could become collateral damage in political battles.
First, Romney pledged to repeal Obamacare. This wouldn't have affected the ICD-10 mandate. But it wouldn't be a stretch for a Romney administration to see it as an unfunded mandate that placed financial and bureaucratic burdens upon physicians. Republicans can be sympathetic to arguments about upgrade costs and administrative requirements that time away from treating patients.
Of course Romney would want to enact his version of healthcare reform. What that would look like is anyone's guess. But there's a good chance that killing ICD-10 implementation could be a way to woo the AMA to support Romneycare.
It is possible that a Romney-appointed HHS leadership could see ICD-10 coding as a tool for trimming waste and fraud from the healthcare system. Republicans do love fighting waste and fraud because no one wants to be seen as in favor of it.
Second, if the Supreme Court rejects the PPACA, Obama needs to go back to the drawing board. He may need the support of the AMA to create a new reform. And ICD-10 implementation could be a bargaining chip. He might need to scuttle it or offer meaningful use type incentives.
Without a Supreme Court victory, all healthcare initiatives are on the defensive.
Now that Obamacare is alive and well, it's going to need the ICD-10 data to achieve its goals.
Source: http://www.icd10watch.com/blog/top-3-stories-shaped-icd-10-implementation-2012
Post a Comment