The U.S. Department of Health and Human Services (HHS) will be giving health insurers, doctors, hospitals and others more time to shift to a new set of diagnosis codes.
HHS Secretary Kathleen Sebelius has announced that the department will push back the date when affected health care entities have to move to the International Classification of Diseases, 10th Edition (ICD-10).
Federal health care laws and regulations that came along years before passage of the Patient Protection and Affordable Care Act of 2010 (PPACA) were going to require health care organizations to make the shift by Oct. 1, 2013.
Sebelius did not say what the new compliance date will be, but she said HHS will work with health care providers to reexamine the pace of the shift.
Health care organizations in the United States and in many other countries use ICD codes to administer just about every aspect of health care administration and finance. Shifting will require changes in medical office procedures, medical billing systems, plan administration systems and insurance company systems, HHS officials say.
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U.S. health care organizations have been using an older diagnostic code system, ICD-9, for years.
America’s Health Insurance Plans (AHIP), Washington, has estimated shifting to ICD-10 from ICD-9 will cost its health plan members about $12 per plan enrollee, or a total of about $3 billion industrywide.
The American Medical Association, Chicago, has been pleading for the government to stop the ICD-10 conversion effort altogether, saying its members are feeling overwhelmed by the cost and complexity of the shift.
The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 – a delay of two years from the compliance date initially specified in the 2008 proposed rule. HHS will announce a new compliance date moving forward.
But many health policy experts have argued that the United States should shift to the ICD-10 system, which was developed by the World Health Organization, as quickly as possible, in an effort to expand access to the kinds of detailed, comprehensive information needed to track health trends and determine whether new treatments and care management strategies are helping patients or hurting them.