Archive for March, 2014

March 27, 2014

URGENT (reprinted from AHIMA) ICD-10 DELAY VOTE PASSES HOUSE, MOVES TO SENATE: YOUR CONTINUED ADVOCACY NEEDED

ICD-10 DELAY VOTE PASSES HOUSE, MOVES TO SENATE: YOUR CONTINUED ADVOCACY NEEDED

This afternoon, the US House of Representatives passed a bill, H.R. 4302 – Protecting Access to Medicare, containing language that would delay the implementation of ICD-10-CM/PCS for one year. In less than 24 hours, AHIMA members made nearly 6,000 phone calls to Capitol Hill and sent many more e-mails and social media posts voicing to legislators a strong opposition to any delay. This bill has now been referred to the US Senate for consideration. This will require an increased effort by AHIMA members to ensure this bill does not pass in the Senate.

The bill mainly adjusts the Sustainable Growth Rate (SGR) for physician Medicare payments. But section 212 of the bill also states that the Department of Health and Human Services cannot implement the ICD-10 code set until October 1, 2015—a year later than the current date of October 1, 2014.

AHIMA is calling on all proponents of ICD-10 to contact their senators and ask that they pass a clean bill to fix SGR and not delay ICD-10. Physician reimbursements under Medicare should not be tied legislatively to ICD-10 implementation.

Senators are expected to vote in the coming days on an SGR fix that could delay ICD-10, but a vote date has not yet been set.

Call Your Senators to Request Removal of Delay Provision

AHIMA is urging members and other stakeholders to call your senators today and voice your opposition to a delay of ICD-10 in the SGR fix. The Senate is expected to vote soon, so it is important to contact your senators as soon as possible. The Web page linked above will allow you to enter your zip code to look up your senators’ contact information.

Phone Script Available Below for Use in Contacting Your Legislator:

Hello, Senator XX:

“My name is XXX and I am a concerned member in your district, as well as a healthcare professional. I am calling to voice my opposition to any language in the SGR fix that would delay ICD-10 implementation until October 2015. CMS estimates that a one-year delay could cost between $1 billion and $6.6 billion. This is approximately 10-30 percent of what has already been invested by providers, payers, vendors, and academic programs in your district. Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished. I urge you, Senator XX, to oppose an ICD-10 delay and let Senate Majority Leader Reid and Chairman Wyden know that a delay in ICD-10 will substantially increase total implementation costs in your district as well as delay the positive impact for patient care.”

The Cost of Another Delay 

AHIMA officials have said that another delay in ICD-10 will cost the industry money and wasted time implementing the new code set. Members of the Coalition for ICD-10, an advocacy group of healthcare associations, vendors, and insurers that support the implementation of ICD-10, said that CMS and other government officials should move forward with the current October 1, 2014 ICD-10 deadline.

We urge you to contact your senators now.

March 7, 2014

MORE BREAKING NEWS FROM MEDICARE REGARDING ICD-10-CM TRANSITION

I provided education via a webinar on Wednesday, March 5 regarding the latest information on the ICD-10-CM transition. In Medlearn article SE1410 Medicare allowed the use of the General Equivalence Mappings (GEMs) for use just during the transition. I expressed my dismay that Medicare would allow the GEMs for actual coding plus stated my belief that the use of the GEMs would result in error and loss of case mix points.

Medicare has just revised SE1410 to now remove all references to the GEMs and the new grid is attached below.

This means that any episode that crosses over the October 1, 2014 implementation date will need to be coded in ICD-9-CM and ICD-10-CM based on the M0090 date of the OASIS, the ‘from’ date on the episode and the ‘through’ date on the episode. Actual coding processes must be used. This does increase the burden to agencies however it will result in fewer errors and rejections of claims. My real concern was that because the GEMs are not complete codes in some cases and include only 7th character A, the MAC systems would not accept the codes and/or HIPPS codes would be affected.

Do not forget that Selman-Holman & Associates, LLC and CoDR—Coding Done Right is standing by to assist you with your consulting, coding and education needs!!

214-550-1477

www.selmanholman.com

www.codingdoneright.com

MORE BREAKIING NEWS FROM MEDICARE REGARDING ICD