Senate Passes SGR Bill. No ICD-10 Delay

Senate Passes SGR Bill. No ICD-10 Delay

The Senate burned the midnight oil late last night, approving legislation to repeal the Medicare Sustainable Growth Rate (SGR) formula. The bill passed 92-8 and without reference to an ICD-10 delay, giving further momentum towards the Oct 1, 2015 implementation deadline and creating increased urgency for those still preparing for the new medical code set, with all major hurdles now cleared.

After passing the House (392 to 37) last month and the Senate (92-8) late yesterday, the Medicare Access and CHIP Reauthorization Act (MACRA) bill will now be sent to President Obama’s desk for final approval. The White House has indicated the President’s commitment to sign it into law.

Last year, House leadership slipped a last minute rider into SGR legislation, delaying ICD-10 for another 12 months. The postponement was the third in six years, blindsiding the healthcare community and discouraging ICD-10 proponents who were left wondering if the code set would ever see the light of day. With the passing of this bill and omission of any further ICD-10 delay legislation, those concerns now appear behind us.

“ICD-10’s momentum has never been stronger,” said Rhonda Buckholtz, AAPC’s vice president of ICD-10. “Healthcare professionals who have been watching from the sidelines should begin preparing immediately, if they haven’t already.”

ICD-10 is the mandated replacement of the ICD-9 code sets used by medical coders and billers to report healthcare diagnoses and procedures. Its implementation will radically change the way documentation and coding are done and will require a significant effort to implement.

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43 Responses to “Senate Passes SGR Bill. No ICD-10 Delay”

  1. Candice Ruffing says:

    This is GREAT news!!!!

  2. Sandy says:

    Yeah I am so excited, I am ready bring it on!!!!

  3. Aidi Kemper,CPC says:

    Cool. I am ready!

  4. Eleanor says:

    I believe this will be a disaster for coders.
    Implementing this process will be a hugh undertaking for computer systems.
    Not looking forward to this at all.

  5. Donna says:

    Hmmmm…all I can say is this will be interesting…I wish I had an option to add an emoticon to this… :0}

  6. Rhonda says:

    I agree with Eleanor. We all know it’s coming, however, I don’t believe that everybody is thoroughly prepared. I believe the largest obstacle will be the Physician’s dictation. As it stands now, a lot of them have a problem with proper dictation protocol for ICD-9. I can’t imagine how much turmoil ICD-10 is going to stir up! I really don’t think that the Physician’s saw training for ICD-10 as an immediate need, due to past delays. I guess they believed it would just be delayed again, and again like most everything else is with Congress. Now, there is very little time to face the reality of it all, and it’s not a pretty sight. I feel that more time is needed for the Physicians to prepare and train. A Coder can know ICD-10 inside-out and be comfortable with it, but if the Physician’s are not prepared for the dictation changes, then it will be disastrous.

  7. Allysen Martinez says:

    I am glad it passed. Last year I was not ready but I am ready this year. It will be growing pains for everyone, but like anything else we will get through it.

  8. VascWhiz says:

    C’Mon everybody! It’s time to put our big kid pants on and act like adults here. We knew it was coming eventually. It’s up to us to make it work. Be part of the solution, not part of the problem. If you are not confident in your providers’ documentation, then find information to educate your providers! If you are not ready – then attend training! There are tons of options out there. Stop complaining and DO SOMETHING ABOUT IT. No excuses.

  9. Kay Castle says:

    One thing is for sure is that it is now here and if you have not prepared yourself it will be harder on you. This has been along time coming and now we can be like other countries that have been using ICD-10 already. You will be able to handle this as you are a coder and you will learn to adapt. I have all confidence in my fellow coders.

  10. MissySimms says:

    I agree with VascWhiz above. We all knew this was coming and it is our job to inform our providers of what their role in all this is.
    As far as most practice management systems being ready, all my systems I work with are prepared and have spent mega bucks to be prepared, so if there are any medical billing software vendors out there that are not prepared, shame on them.

    Lets go!!

  11. Tina Welker, OCS says:

    I seriously feel that we as Certified Coders are ready but personally my Doc’s and my other staff will be so overwhelmed. Training is the key and lots of it!

  12. Joe Cronin says:

    From a large provider’s perspective, this a major, major multi-billion-dollar boondoggle. No increase in quality, no decrease in cost (quite the contrary!), no increase in patient accessibility or acceptability, etc. Just frigging tragic!

  13. Grace DeBold says:

    I agree with Joe C. This is a total waste of time and money. I’m pretty confident that 3 of my docs will retire over this waste.

  14. Cory Mc. says:

    So we should spend money to train and update software systems when ICD 11 is due only 2 years later in 2017? My understanding is that ICD 10 was developed by the WHO and is primarily used by socialist medicine countries. It’s main purpose is for gathering data and seeing trends. In our capitalist medicine system, however, it will be exploited by insurance companies to deny payment or at least prolong it. I cannot see how it will make medical treatment in America better.

  15. Balaji prasad says:

    Hi all,

    Rather complaining about the de-merits. Let we grab it and get used to this!!!

    We all need to do this act together to make it successful…

  16. Guy Incognito says:

    Cory, ICD-10 was released 20 years ago and more than 25 countries use it for reimbursement purposes, with another 110 using it for data. Meanwhile, ICD-11 is due in a couple years in its first form, but will again have to be modified for use in the U.S. We can’t continue to use a system from the 1970s for another 20 years, and many of the fundamentals of ICD-11 are based on ICD-10, so the jump would be even more catastrophic for every part of the industry.

    If you cannot see how the capture of more specific data, which can follow diseases through the process, as well as capture more information about devices and treatments used, will improve medicine, well, I’m not sure how you think medical advancements are made.

    If you want to prevent insurance companies from denying payment, then pushing off learning how to use the system will only guarantee that.

  17. Cory Mc. says:

    Guy,
    Maybe my point didn’t come across correctly. I’m not by any means against data trends and collection and advancement of medicine. The point I was trying to make was this. First, I have already invested time and money on training only for Congress to push back the deadline at the last minute. I don’t want to go through it again in 2 years for ICD 11. Might as well forget about ICD 10 and start preparing for 11. Finally, I say again that in our system it will increase denials in a large way

  18. TQ says:

    Cory MC. You are right. There are medical advantages to ICD10. However we live in the reimbursement world where we know just how insurance companies use this sort of thing to slow down reimbursement!!! Also they are not always ready and so the Dr. Have to pay us to dedicate the insurance companies on the proper use of the codes!! So really the burd en ends up on the Dr’s offices and the small practices just can’t afford that. Wish the was a better way to hold them accountable!!

  19. Sathyamoorthi Dhasharathan says:

    Yes, We are Ready for it.

  20. Ramakirshna Jangili says:

    I am waiting………

  21. krishnaraaj says:

    Thats great news to know.

    Coders around the globe are heading towards ICD-10 encounter.

    Hope this should increase the coding domain specificity and quality hence, obviously be coder-friendly,since we the coders are supposed to get used with it.

    Irrespective of Nations,projects, we all welcome ICD-10 on OCTOBER 1ST 2015.

  22. I10now says:

    This is greeeeeaaaaat news!

  23. Cherish says:

    Yeah, I’m still not holding my breath. :) If it happens, it happens. If it doesn’t, it doesn’t. We will see.

  24. Red Raleigh says:

    Cory: ICD-11 will be built on ICD-10 so the transition should not be as jarring as ICD-9 to ICD-10. Also, you are assuming ICD-11 will be pushed out in 2017 as stated by WHO. That is highly unlikely. ICD-10 took 20 years.

  25. Trina Neilson says:

    GREAT NEWS!!!

    Let’s do this!!!

  26. Bev Faircloth, RHIT, CCS says:

    ICD 10 is a long time coming, don’t want to be a doubting Thomas but will beleive it when October 1st gets here…
    Also agree with A Martinez… “It will be growing pains for everyone, but like anything else we will get through it.” Coders have knowledge of A & P, disease process, medical terminology, pharmacology and understand the coding rules and guidelines etc. We will be fine.

  27. Mary Nunez says:

    My company and I have personally made it our business to get our practices ready. We have held free webinars, personal visits, template revamping, superbill revamping and more in order to make our lives easier and get our number one priority paid; our clients.

    My concern is not our clients or our abilities to code, but the insurance companies and clearinghouses. It is your jobs to ensure there are no hiccups. We meet once per week through Skype and we talk together about these changes and we come up with great solutions. If you all need guidance, contact me. It is not as hard as you think.

    Mary Nunez, President
    Advantage Physician Billing and Consulting Inc.

  28. Angela J says:

    Well, those of you who are saying “but we’re not ready” – you have 5 months to get hopping! Should have been doing something to prepare all along. But as with many other aspects of people’s lives, they procrastinate until they’re backed against the wall. Then they cry like that. Well, guess what? Your delay is over-time to get ready!
    This implementation is a long thing in the making. Coders, we’re ready…work with the doctors a little at a time…even if it’s 2 hours a week. They will get it.
    Those of you saying doctors will retire over this…well – in my opinion that is just silly.
    The problem as I see it, is doctors don’t want to commit to giving their patient a diagnosis code. That’s why we see so many probably, might be, could be, seems like… etc. ICD10 will push them to make a firm diagnosis.
    Oh well. Be confident in your medical decision making and stop spending your days worrying about getting sued.
    I am so glad the delays have stopped and we’re moving forward with this.
    And to those saying it won’t affect patient care…think again. yes it will. More specific chart notes/documentation is never a bad thing. It will allow better research and disease tracking. We’ve run of codes. Not to mention that we in the USA are nearly the only ones still using ICD9. We’ve upgraded ICD versions 9 times before – why is this one SUCH a huge deal?

  29. Dan says:

    Yes its coming
    but it is idiotic, and does nothing to make life better for doctors or patients. It is just a way for insurance companies and the government to track us, control us and deny us. And it will cost a fortune to every practice to implement and in slowing us down.

    Acting like a big kid and accepting it sounds good, like sheep being led to slaughter, with Obama keeping us all in line.

    Dr. Dan

  30. Kevin says:

    Dr. Dan,

    I am surprised that all you are concerned about is reimbursement and government control. You would think that specificity would be something that a trained physician and others in healthcare would want. Seriously, do we really want to be the last country in the world to change a code set that was introduced before cell phones, personal computers and modern medicine? Should we have stayed with blood-letting also? If you want to stay with ICD-9, please turn in your phones and your color televisions….

  31. Jeanne Reid says:

    I THINK THIS WILL BE A DIASTER. IT’S TOO DETAILED AND TAKES TOO LONG TO CODE A SINGLE CHART. PRODUCTION WILL SLOW DOWN VERY MUCH. REIMBERSEMENT WILL SLOW DOWN A GOOD BIT. MOST OF THE PHYSICIANS HATE THIS ICD-10 SYSTEM. YOU WILL PROBABLY SEE A LOT OF CODERS JUMP SHIP. THERE ARE SOME CODERS INCLUDING ME THAT GET PAID BY THE CHART. IF YOU HAVE TO CODE A LONG LENGTH OF STAY THAT TAKES THREE TO FOUR HOURS TO CODE IN ICD-9, JUST IMAGINE HOW LONG IT TAKE TO CODE THAT SAME CHART IN ICD-10. HAS ANYBODY THOUGHT THIS THROUGH? IF CODERS LIKE ME THAT GET PAID BY THE CHART, DON’T GET A RATE INCREASE WILL PROBABLY QUIT BECAUSE THEY CAN’T MAKE A LIVING DOING THIS JOB. I WOULD PROBABLY MAKE MORE MONEY WORKING AT McDONALDS. THIS WHOLE ICD-10 SYSTEM JUST SUCKS.

  32. Rhonda says:

    I commented early on in this Saga, and one thing is evident. Just like most comment boards this has turned into people attacking each other for their opinions, and the actual topic of ICD-10 is getting lost in the mix. Sad…

  33. GIRISH P S says:

    YES……THIS IS THE TIME TO SHOW YOUR TALENT.I AM ALWAYS READY FOR THIS TYPE OF CHALLENGES OF LIFE…..!!!!!

  34. Hrushikesh J surdi says:

    I AM SO HAPPY FOR ICD 10CM IMPLEMENTATION IN THIS YEAR. I READY TO ACCEPT THIS CHALANGEEEEEEEEE.

  35. JB says:

    I find it quite presumptuous to declare “No ICD-10 Delay.” The physician & insurance company lobbyists will have the final say & there is plenty of time for them to apply pressure to Congress.

  36. Sally Thibodeaux CCS,CPC,LPN says:

    I hope it really does happen! We have had several years to prepare for this and learn the new code set. Anyone that isn’t ready can only fault themselves. This is
    Only my opinion.

  37. Kacey says:

    So it’s about time the US is catching up with the rest of the world. Other countries have implemented ICD10, and are doing just fine. It seems we are always the last to embrace changes in the HealthCare Industry. As I quote VascWhiz above…”Time to pull and put on the big boy pants.” Guys…we got this, we can do this!!!! O’ Ye of little faith…It will be a handy cap for us all, payor as well as practice; but a change has come. It’s not like we were blindsided, right?

  38. Candy Gantt says:

    I am ready taking a class this summer for ICD 10.

  39. stacy walk says:

    I am ready have bbeen studying icd-10 for a couple months. Glad it is going forward. It will be tough at first but I think it will be well worth it.

  40. tasheen says:

    I have been studying and practicing ICD 10. My issues are my nurses’ I work in home care and it is a challenge just to get the correct info from them and the doctors’, I have to stress to them now about left/right, which part of the body. what kind of wound. That’s is my concern.

  41. josef novak says:

    A colossal waste of energy and resources to monitor irrelevant metrics that neither advance diagnostics nor will offer any sort of dynamic that could influence treatment. It will comprise worthless statistical data – like how many turtles actually leave the galapagos islands and later return. All that for only a few BILLION healthcare dollars – dollars that come from physicians and hospitals in the wake of barbarians feeding us new technologies to facilitate a bogus paradigm akin to Y2K.

    Soon we will be able to track which lung is more commonly infected with pneumonia, or which leg is more often broken in auto accidents – excelsior, to be sure. But we are a country of magnificent wasters of all things and consumers of frivolous shiny objects that add nothing to our lives but anxiety – ah, but now we can better measure that anxiety with ICD-10.

  42. Anne says:

    For the physicians and other medical staff who have been dragging their feet on this, the time has come, get ready…no more delays. You are costing the rest of us who have performed our due diligence, millions of dollars each year this is delayed. I understand change is difficult, but let’s catch up with the rest of the world, there are very good reasons for ICD-10-CM implementation, one of which is better care.

  43. Frank says:

    I am a surgeon not a coder. This will not help me or my patients. It will make the bureaucracy of health care grow. It will make the process of providing care less efficient. It will make going to the doctor’s office feel more like a trip to the motor vehicle administration. It will further discourage bright young people from going into health care, along with the lack of tort reform, poor insurance reimbursement rates, soaring overhead, the demand for 100% perfect outcomes even in abysmal circumstances, etc, etc, etc. ICD 10 is not the worst thing to ever come down the line but it is just one more straw on the back of a camel already buckling at the knees.

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