The Winter of Discontent and How About That April Fools? May 27, 2014


TMI’s ITen Tuesdays – Keep Calm and Code On!

By Holly Cassano, CPC, AAPC ICD 10CM Certified, Director of Coding Education and Compliance for Tactical Management Inc., (TMI)

The Winter of Discontent and How About That April Fools? May 27, 2014

Well, if you don’t know by now or have been living under a rock for the past six weeks, ICD 10 is DELAYED AGAIN!  The Zombies didn’t do it, nor did any Flying Monkeys or UFO’s, it was good ole’ Congress, The AMA and The President who secured the one year delay.  Some of you may be unaware, but this is the third time that action taken by the president has delayed the nation’s healthcare system’s attempts to adopt ICD-10.

On March 26, 2014, the Sustainable Growth Rate (SGR) draft legislation included legislative language for a one-year delay in ICD-10 implementation to Oct. 1, 2015. Congress voted in favor of it as well and on April 1st, 2014, President Barack Obama signed the Protecting Access to Medicare Act on April 1. The legislation prohibits the U.S. Department of Health and Human Services (HHS) from implementing ICD-10 before October 2015. How’s that for an April Fools’ Day?  Medicare never saw it coming, nor did the rest of the healthcare community, including The AAPC and AHIMA, the two governing bodies for Certified Coding Professionals.

Educational Fallout

As surprised as most of us were when we learned President Obama signed the one year delay into law, I have to say, as an educator, my thoughts turned to those who were spending their dollars in school learning the coding profession.  Many of these schools that teach coding unfortunately decided to only teach ICD 10 over the past year and not teach ICD 9.  These students are now severely and negatively impacted by this unprecedented delay and are going to struggle for some time financially, as they will not be employable until ICD 10 goes into effect or they go back and learn ICD 9, if feasible.

Healthcare Community Fallout

The negative financial impact on the healthcare community cost of the new delay was certainly on the mind of healthcare consultant Lyman Sornberger, former Cleveland Clinic Hospital Vice President of Revenue Cycle, who during his tenure committed the system to be among the nation’s earliest adopters of ICD-10.

Sornberger, now CEO and president of LGS Health Care Consultants had this to say, “Cost estimation of the delay for a 300-600 bed hospital is (between) $250,000 to $450,000 and that the cost estimation of the delay to hospitals with a bed size of greater than 1,000 beds is in excess of $750,000.”

To read more, please click on the link to ICD 10 Monitor:

And Now a Word from CMS

On May 1 2014, there appeared a brief but distinct reference to the ICD-10 deadline in the 2015 Inpatient Prospective Payment proposed (IPPS), rule, uncovered by ICD 10 Monitor and found on pages 648, 1065 and 1074. The references to the delay are stated by CMS as follows:

•       CMS states on page 648 that “The ICD-10-CM/PCS transition is scheduled to take place on October 1, 2015.”

•       “On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015”.

•       “U.S. Department of Health and Human Services expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015.”

•       “The rule will also require HIPAA-covered entities to continue to use ICD-9-CM through September 30, 2015.”

To read more on this topic, please click on the following link to 


ITen Free Zone:

For those of you looking for a great free ICD 10 coding tool, check out, it includes updated coding information for both ICD-10-CM and ICD-10-PCS. 


Final Thoughts

My recommendation to the healthcare and coding communities is the same as the AAPC and AHIMA and CMS, “Stay the course” and continue on with preparations and “Dual Coding” efforts.  ICD 10 is coming and much like HIPAA implementation, we will get to that lightening round and join the rest of the free world and commence with utilizing ICD 10.

Code On!!


Holly Cassano, CPC, AAPC ICD 10CM Certified

Director of Coding Education and Compliance for Tactical Management Inc., (TMI)




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