The following alert was authored by our McGuireWoods colleagues Kimberly J. Kannensohn and John C. Saran.
On April 1, 2014, President Obama signed the Protecting Access to Medicare Act of 2014 (the Act) into law, thereby delaying until at least Oct. 1, 2015, the mandate of the Centers for Medicare and Medicaid Services (CMS) for healthcare providers to implement the ICD-10 coding system. The Act expressly prohibits CMS from enforcing its previous Oct. 1, 2014 deadline and delays reductions in Medicare reimbursement rates for physician services. Large healthcare providers and payors have already spent hundreds of millions of dollars preparing for this deadline. Conversely, smaller providers, who were unprepared for the implementation of ICD-10, are welcoming this one-year delay. However, the ICD-11 system will be released by the World Health Organization in 2017, which might cause CMS to further delay its mandate.
The ICD-10 coding system is a set of more than 68,000 codes that classify medical diagnoses and procedures for payment. The American Medical Association indicated that the move to ICD-10 would not be easy, but that the new system affords the benefits of greater detail and expanded concepts for injury. The ICD-10 system also accounts for recent advances in medical technology. While the United States is the only industrialized nation not to use the ICD-10 system, the high implementation and training costs facing providers put pressure on Congress to ultimately delay the ICD-10 deadline.