Correction: A previous version of this story said that the bill would require CMS to accept dual coding of claims.
Dive Brief:
- Rep. Diane Black (Tennessee) has introduced a bill requirning an 18-month transition period to test the submittal of ICD-10 claims during which time providers would not be penalized.
- H.R. 2247, "Increasing Clarity for Doctors by Transitioning Effectively Now Act (ICD-TEN Act)," requires CMS not allow any denials based on "the use of an unspecified or inaccurate subcode."
- The bill also requires the agency to conduct "comprehensive end-to-end testing" of the system, report to Congress on the functionality of the system and prove the system was working.
Dive Insight:
Rep. Black urged fellow legislators to co-sponsor the bill in a letter, saying that "we must ensure the transition does not unfairly cause burdens and risks to our providers, especially those service Medicare patients."
The bill is dividing two major industry associations. Robert Tenant, director of health information technology at the Medical Group Management Association (MGMA), supports the bill. He said it does not address all concerns, but does cover most critical issues.
The American Health Information Management Association (AHIMA) stands strongly against the bill, saying ICD-10 contingency plans are working well and will ensure an effective transition in October. The group said in a written statement that CMS testing over 12 months resulted in only 3% of rejected claims due to invalid coding. To reduce loss "AHIMA recommends that CMS grant 'advance payments' to any physicians that do experience cash flow disruptions as a result of the ICD-10 transition."
Want to read more? You may want to read this story on the AMA support for a bill to skip ICD-10 entirely or this GIF guide to the most important animal ICD-10 codes.