Physicians in Tennessee have been encouraged by the Tennessee Medical Association (TMA) to “continue improving clinical documentation” in preparation for ICD-10 changes despite the fact that the U.S. Senate on the last day of March voted to delay the implementation of ICD-10 until October 1, 2015.
The Senate vote of 64-35 led to the passage of a House-approved measure that would delay a scheduled 24 percent cut to Medicare physician reimbursement rates and push the ICD-10 compliance deadline to 2015.
A statement issued by the TMA shortly after the Senate’s action stated, “We encourage physicians to continue improving clinical documentation to not only transition into ICD-10, but also meet new requirements for value-based reimbursement, ACOs and other emerging payment models. TMA will continue supporting Tennessee’s medical practices in these efforts through education, legislative advocacy, special events and other programs
“For the past three years, TMA has provided education and other resources to help our members fully prepare for the October 2014 deadline. Practices that were on track to successfully transition are now ahead of the curve. For others, this latest delay means more time to prepare.”
U.S. healthcare organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch means that healthcare providers and insurers will have to change out about 14,000 codes for about 69,000 codes.
Before Congress’ action last month, the ICD-9-CM code sets that currently are used to report medical diagnoses and inpatient procedures would have been replaced by ICD-10. The looming changes raised the question, would the Memphis medical community be ready for the change?
Since so many people and organizations would have been affected, that question was an important one. The users of the codes include practitioners, insurance carriers, government regulatory bodies and healthcare research personnel. Other entities that would have been impacted include hospitals, pharmacies, physical therapy providers, home healthcare providers and skilled nursing facilities.
The TMA expects all practices in the state to incur additional testing timelines and costs. The organization says it will communicate related updates as they are available.
TMA expects the transition from ICD-9 to ICD-10 to bring drastic changes to a physician’s practice. It forecasts the increase in coding will jump from 16,000 to 68,000 alone. All “covered entities” – as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) – will be required to adopt ICD-10 codes for use in all HIPAA transactions.
To avoid disruptions in patient care and reimbursement, TMA suggests physicians must be prepared. A successful transition from ICD-9 codes to ICD-10 codes will require significant planning. At minimum, organizations should consider the following:
Ensure top leadership understands the scope and significance of the ICD-10 implementation and transition
Assign responsibility and decision-making authority for managing the transition
Plan a comprehensive and realistic budget
Ensure involvement and commitment of all internal and external stakeholders, and
Adhere to a well-defined timeline.
The TMA says it can help with this transition through online courses, access to experts and ICD-10 transition toolkit and software.