July 7, 2015
Physicians’ practices have been so slow to prepare for the ICD-10 transition that the American Medical Association (AMA) and other physician groups have warned of a healthcare industry crisis starting October 1, the ICD-10 deadline. They have strongly campaigned for a reprieve for physicians, supporting one Congressional bill that would kill the ICD-10 initiative outright, and two others that would delay penalties for up to two years. CMS has answered the call by announcing new relief measures — for physicians and eligible professionals (EPs) only.
CMS announced Monday July 6th that it will adopt proposals made by the AMA to ease the transition to ICD-10 coding for physicians and other EPs. These measures apply to Medicare Part B claims only. They do NOT apply to hospitals or other entities covered by ICD-10 regulations. ICD-10 codes will continue to be required for dates of service beginning October 1, but the impact on physicians/EPs will be eased as follows:
There is no doubt that this is good news for physicians. These measures help to mitigate some significant financial risk related to the transition. However, they do nothing that will allow physician practices to continue using ICD-9, or to slow down their ICD-10 preparations.
CMS’ concessions to “physicians only” may be bittersweet for any hospitals that are behind on their ICD-10 preparations. Recent surveys have indicated that many small hospitals in particular — up to 50% — have made little progress in the last year. It would appear that hospitals that may have been holding out for another delay or some other relief will be disappointed.
This development should be a strong wake-up call to hospitals and other covered entities. They have not been given the break physicians are receiving. ICD-10 remains on target for October 1, penalties and all.
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