Article by Mary Butler, associate editor at the Journal of AHIMA. “This article was originally published on the Journal of AHIMA website on February 4, 2015, and is republished here with permission.”

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A key Congressional committee will be holding a stakeholder hearing on ICD-10-CM/PCS implementation next week. The “Examining ICD-10 Implementation” hearing, set for 10:15 am ET on February 11, is being held by the influential House Energy and Commerce Committee’s subcommittee on healthcare, which is chaired by Rep. Joe Pitts (R-PA).

“This hearing is an important opportunity to hear about the state of preparedness of all those involved and ensure that we are continuing to move forward in health care technology,” Pitts said in a press release announcing the hearing .

Back in December, House Energy and Commerce Committee Chairman Fred Upton (R-MI) and House Rules Committee Chairman Pete Sessions (R-TX) issued a statement saying that they would hold hearings on ICD-10 and stay in communication with the Centers for Medicare and Medicaid Services (CMS) “to ensure that the [ICD-10-CM/PCS] deadline can successfully be met by stakeholders.”

The Congressmen noted in the statement that “it is essential that we understand the state of preparedness at CMS. Following the most recent delay of ICD-10, we heard from a number of interested parties concerned about falling behind or halting progress.”

AHIMA staff will attend the February 11 hearing and closely monitor any developments that result from it. Panelists testifying at the hearing will include stakeholders who both oppose and support implementing ICD-10 on October 1, 2015.

The Majority Memorandum, a witness list, and witness testimony will be available online here as they are posted.

Historically, this subcommittee has played key roles in healthcare legislation and in the ongoing debate over the SGR patch—which last year included language delaying ICD-10. Another SGR patch may once again be voted on by Congress in the coming weeks if a permanent fix is not enacted. The House Energy and Commerce Committee also includes physician members of Congress who have a specific interest in the implementation of ICD-10.

AHIMA officials have said they are encouraged by the hearing announcement, and feel it is a chance for an open and frank discussion about ICD-10, the current industry readiness, the impact of any future implementation delays, and the best path to move forward with implementation. The initial statement announcing the hearings came during wide grassroots activism in support of no further ICD-10 delays on the part of AHIMA, the Coalition for ICD-10, and other supporters.

The House subcommittee hearing will be held the day after the Coalition for ICD-10’s Capitol Hill briefing on Feb. 10. The briefing will discuss rural provider and payer readiness for ICD-10, and include perspectives from hospital and physician groups who support the current October implementation deadline.

Click here for a list of the House Energy and Commerce Committee Subcommittee on Health’s members.

The hearing webcast will be available to watch live at http://energycommerce.house.gov/.

CMS conducted another successful acknowledgement testing week last month. Acknowledgement testing gives providers and others the opportunity to submit claims with ICD-10 codes to the Medicare Fee-For-service (FFS) claims systems and receive electronic acknowledgements confirming that their claims were accepted. While providers are welcome to submit acknowledgement test claims anytime, during the November testing week, testers submitted almost 13,700 claims.

More than 500 providers, suppliers, billing companies, and clearinghouses participated in the testing week last month. Testers included small and large physician practices, small and large hospitals, labs, ambulatory surgical centers, dialysis facilities, home health providers, ambulance providers, and several other physician specialties. Acceptance rates improved throughout the week with Friday’s acceptance rate for test claims at 87 percent. Nationally, CMS accepted 76 percent of total test claims. Testing did not identify any issues with the Medicare FFS claims systems. This testing week allowed an opportunity for testers and CMS alike to learn valuable lessons about ICD-10 claims processing.

To ensure a smooth transition to ICD-10, CMS verified all test claims had a valid diagnosis code that matched the date of service, a National Provider Identifier (NPI) that was valid for the submitter ID used for testing, and an ICD-10 companion qualifier code to allow for processing of claims. In many cases, testers intentionally included errors in their claims to make sure that the claim would be rejected, a process often referred to as “negative testing.” The majority of rejections on professional claims were common rejects related to an invalid NPI. Some claims were rejected because they were submitted with future dates. Acknowledgement testing cannot accept claims for future dates. Additionally, claims using ICD-10 must have an ICD-10 companion qualifier code. Claims that did not meet these requirements were rejected.

On December 5, 2014, the American Hospital Association (AHA) issued a letter to Congressional leaders on behalf of its members imploring them to continue supporting the ICD-10 implementation date of October 1, 2015.  Citing additional costs and disruptions of further delays along with the improved collaboration between the payer, provider, and government communities, the AHA is confident that the industry will be ready for the transitions which is now less than one year away.

Click here to read the letter.

Written by Chuck Buck, ICD-10 Monitor

Click here for full article.

Despite a significant lobbying effort mounted by a small but very vocal minority within the healthcare industry, the implementation of ICD-10 is expected to proceed without further delay.

The failed push marked a third attempt to delay the Oct. 1, 2015 ICD-10 implementation deadline well into 2017. Members of Congress rejected the request to include language that would again delay ICD-10 in the lame-duck omnibus spending bill that was passed by Congress on Dec. 11 and ratify by the Senate on Dec. 13.

Failing to delay ICD-10 by using a legislative maneuver – slipping language in a massive spending bill – represents a crippling blow to opposition that will make future efforts to revisit the matter very difficult. Congress made its decision not to hold up ICD-10 after hearing opinions about it from many voices in the healthcare community, including well-organized groups of physicians. During the course of this debate, there were many myths perpetuated, not to mention promises of doom and dysfunction, but also strong cases for proceeding with the coding system upgrade.

While fans of ICD-9 will no doubt use the March 2015 sustainable growth rate (SGR) bill to make another run at delaying implementation, it will be hard to convince members of Congress that more time is needed. If Congress didn’t see the need to enact a delay in December, why would they be convinced to delay months later in March?

Advocates for ICD-10, including the American Health Information Management Association (AHIMA), national and regional hospital associations, and physician groups are applauding the decision by Congress. Across the industry, companies and healthcare organizations have invested millions of dollars preparing for ICD-10. Many physicians have planned ahead for ICD-10 by taking advantage of low- and zero-cost education resources made available by the government.

Upon hearing the news that ICD-10 cleared a major legislative hurdle, organizations issued statements expressing their support for moving forward on this long-awaited and much-needed move to implement.

“Congress issued a strong message and sent the ‘delay ICD-10’ crowd back to the bench,” said Chris Powell, CEO of Precyse, a provider of health information management solutions and staunch advocate for ICD-10.

“I predict that, in a short time, the industry will look at the upsides of a modern coding system and wish that ICD-10 had arrived much sooner,” added Powell. “The vast majority of the industry is ready to move beyond ICD-9, an antiquated and very limited system that is woefully insufficient for hospitals, physicians, and patients. We have a myriad of best practices and learnings gained from other countries’ migrations to ICD-10 before us, and we now have the green light to put ICD-10 into motion.”