ICD-10 Grace Period: What’s the Downside?


A new bill introduced into the US House of Representatives proposes a two-year “grace period” for accepting codes submitted in ICD-10-CM. The bill, H.R. 2652Protecting Patients and Physicians Against Coding Act of 2015, was introduced by Representative Gary Palmer (R-AL-6) on June 4.

The legislation is the third ICD-10-related bill to be introduced into the House of Representatives in the last five weeks. On May 12, H.R. 2247, the Increasing Clarity for Doctors by Transitioning Effectively Now Act (ICD-TEN Act) was introduced by Rep. Diane Black (R-TN-6) calling for an ICD-10 transition period.  On April 30, H.R. 2126, the Cutting Costly Codes Act of 2015 was introduced by Rep. Ted Poe (R-TX-2) seeking to outright stop the replacement of ICD-9 with ICD-10.

H.R.2652 would create a two-year grace period where healthcare providers’ ICD-10-based claims submitted to Medicare and Medicaid would not be denied due to ICD-10 coding issues. Implementing this grace period would ensure radiologists are not negatively impacted while ICD-10 is fully implemented within the healthcare system.

Break Away from the Static

Similar to Black’s bill, H.R. 2652 would not delay the October 1, 2015 implementation deadline for ICD-10 use, but would require the Centers for Medicare and Medicaid Services (CMS) to pay for claims even if not coded to ICD-10 specificity. Palmer states in the letter that this grace period would create a “true transition” to the new code set, and is needed in order to allow the industry to grow accustomed to ICD-10 over a period of time without being penalized for inherent weaknesses in the healthcare finance system.

As always, ADVOCATE will keep you up to date on this and all issues impacting radiology as they become available.

Best regards,
Kirk Reinitz, CPA