March 26, 2014 | | Comments 6
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News: Congress sneaks ICD-10 delay language into SGR bill

Dear ACDIS members and CDI professionals,

A new bill introduced in the House and Senate includes a small, rather buried section that would delay implementation of ICD-10 for another year, to Oct. 1, 2015. The main focus of the bill is a fix to the Sustainable Growth Rate (SGR), which is necessary. This small provision of the bill is not.

The bill is expected to go to the House floor tomorrow, March 27, for a vote. In accordance with the American Health Information Management Association (AHIMA), we urge our members to contact your local congressman and request removal of the ICD-10 delay provision. See the AHIMA release here, which includes a lookup tool to find the number of your local representative of Congress:

ICD-10 is necessary, and it’s coming. Further delay only hinders our ability to better capture the necessary specificity of the conditions our physicians and facilities are treating today. It also hurts the work many of our members have already done to prepare for the Oct. 2014 deadline, and undermines our credibility as CDI specialists. And there is the cost to consider: CMS estimates a one-year delay could result in additional costs of $1 billion to $6.6 billion.

Please contact your representative in Congress today and ask them to take the ICD-10 provision out of this bill. Help us spread the word and tell Congress, tell your colleagues, tell your friends why ICD-10-CM/PCS implementation is so important to the work you do every day. #NoDelay!


Brian Murphy

Director, ACDIS

Entry Information

Filed Under: ICD-10


Brian Murphy About the Author: Brian Murphy, CPC, is director of the Association of Clinical Documentation Improvement Specialists (ACDIS). Brian is also an executive editor in the revenue cycle division of ACDIS’ parent company HCPro, Inc.

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  1. This did pass in Congress today-next step it goes to a Senate vote tomorrow.

  2. I am not optimistic that this bill won’t pass the Senate. The utter disaster of the ACA rollout and low enrollment numbers to fund the law make this bipartisan bill likely to pass both chambers. They have delayed business and individual mandates, delayed enrollment deadlines, it is easy to conclude that the SGR delay will also stand.

  3. Just to put some perspective on this, I am presently attending classes for ICD-10 and learning the new skill set. My class is set to conclude at the end of May. My classmates and I have all paid our way thru, and all of our 2014 ICD-10 books have been distributed. Of our class, one is a nurse, one is already a coder, another is a transporter at a local hospital, one a CNA, and the rest of us are either partially employed (I am presently working 2 jobs that pay less than I was making when I was 30, I am now in my 50’s, and still not enough to cover my bills. There are approximately 25 of us getting ready to take on ICD-10. Our teacher is awesome and not only teaches, but is a coder herself, highly educated and completely devoted to the ability of ICD-10 to greatly increase the transparency of how ill a patient is, but of additional care that may be needed to set that patient in the best possible position to heal and recover. The ICD-9 was implemented in 1967, long before the DaVinci robotic surgery, insulin pumps, education on diseases, scans, etc that are not being completely captured with the present and outdated ICD-9 system. Not only does ICD-10 this allow information about a patient to give a more complete picture of the patients health, but it also will allow much more transparency into more effective treatments, morbidity, progressions of illness and disease, but will allow hospitals and physicians to be more accurately reimbursed for procedures and treatments, but will allow the CDC to more quickly ascertain what flus, colds and infectious agents are in the works and may also be better prepared with this earlier information to develop vaccines to enter the market in time for flu season based on those early reports. That’s just the stuff I, a plebe in this fight, know. There is much more to be gained. The resistance is more about putting things off, for no good reason! Contact your senator and tell them to get this done now! No more foot dragging!

  4. Senate approved it.

  5. Hi,
    First of all, I think you guys do a fabulous job and you sometimes have to do this while working with physicians who can be difficult.
    I have a question. The intent is to find out what you think because I am curious.
    Do you think coders will be needed in the future if doctors dictate, in words, what they did and what they think (Problem List and then something about each problem)?
    Now, with Dragon Dictation and Optical Recognition Software, will coders be needed? Will the words be able to be made into codes by a computer if doctors do their job and dictate the problem list and then what they think about each problem (right now a root-cause of issues in this area is physicians who do not document well (copy and paste, cloning, incomplete notes and reports).
    If coders will not be needed, can you morph into something else to do that will be important as we phase into Accountable Care (Providers will be accountable to the payers and the patients) and Value-Based Care (Value = Quality /Cost).
    Is there any discussion about how technology may impact coders now and in the future? — Jeff

  6. Dr Epstein, First, thanks for chiming in and recognizing the hard work that we do! I’m doubtful that coders will ever be replaced by dictation software. There are many guidelines that are in place to insure that proper codes are assigned and that the appropriate DRG is billed. For instance…a patient is admitted with a diagnosis of “altered mental status”. While this is a symptom diagnosis that surely has an underlying disease process that will be discovered, through the course of the patients admission, many providers will document differential diagnoses and order corresponding work up. Is it encephalopathy? CVA? Brain mass? This will not be able to be ascertained through picking up key terms throughout the chart and coded accordingly. For instance, it may have been due to hyponatremia secondary to SIADH. No way for the computer software to know this. That’s why we query the physician and hope that he puts it in his discharge summary as “principle reason for admission”. But we usually aren’t that lucky. Maybe someday an IT genius will come up with this technology, but for now we are nowhere close.

    Hope this was helpful:)

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