Monday, September 08, 2014

Headline Chuckle of the Day…Firm Date for ICD-10 Switch Still Not Raising Urgency

Since 2003 I have heard that the ICD-10 switch is “FIRM”. No wishy-washy, dilly-dally for the ICD-10, no sir, the date is set in stone. Well, maybe soft concrete. Would you believe chalk on concrete in a rainy climate?

So I got quite a chuckle when I saw an article with the statement of a firm date:

Now that there is a firm date for the transition to the new ICD-10 coding system -- and it's little more than a year away -- you'd think physician practices would be rushing to get ready, but that doesn't seem to be the case.”  Shocked, shocked I say.

Earlier this year, I had the privilege of sitting through several webinars about ICD-10 and how it would work, and two things became evident. First, that the ICD-10 is so dramatically different from ICD-9 coding that physicians will explode en mass if asked to adopt it,  and seconf, that no one on any webinar believed that it would be implemented in October of 2014. The first question always asked on these webinars is “Will implementation be delayed again?” The answer was always a definitive NO. But it was delayed …

The new ICD-10 coding system was originally set to take effect this October, but was then pushed back at least a year in a bill -- the Protecting Access to Medicare Act of 2014 (H.R. 4302) -- which was signed into law in April.

However, the bill didn't specify an exact date for the switch -- saying only that the Department of Health and Human Services "may not, prior to Oct. 1, 2015, adopt ICD-10 code sets," meaning that it could be later than that date. This left physicians in limbo, without a definite date for a switch.”

Now CMS is complaining that doctors are not getting ready:

Physicians have been pushing back on their practices' efforts to get ready, "saying, 'Why should I invest because they're moving the date every year,'" said Robert Tennant, senior policy adviser for the Medical Group Management Association.” And there's this: the vendors aren't ready, either. And why not? Well, they "don't want to invest much either, thinking the date may never stick. It's a terrible situation."

The reality is that medical offices spend hours on developing protocol, attending Webinars, and training, only to have the date of implementation pushed back time and time again. It is not only ICD-10, but the many and various government initiatives that are very poorly designed, pushed to be implemented and then, when there is pushback from the medical community, it is delayed, but only after these offices have invested time and money to get ready. I recently discovered that a program that was to go into effect on April 1 of this year, after being pushed up from January 1, 2014, was instead suspended. I spent hours on training for this initiative and developing the data gathering process, only to discover that, as the manager who told me the news stated, “I wasted my time.”

Why would any doctor or manager, already working 50 to 60 hours a week, want to spend even more time on a government program that has been pushed back so many times that it's now an industry joke? The answer is that they will not waste their time, regardless of any strongly worded guideline from the government.

Oh and how is that metric initiative going?
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