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Focus on Regulation

CMS Delays ICD-10 Deadline

The Centers for Medicare & Medicaid Services issued a final rule that (a) delays by one year the date on which covered entities must comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10), and (b) establishes a unique health plan identifier (HPID). This final rule is promulgated pursuant to section 1104 of the Patient Protection and Affordable Care Act, which requires HHS to issue regulations designed to simply administrative requirements.

ICD-10 Delay

In a final rule issued in 2009, HHS adopted the ICD-10 code sets as the HIPAA standards.  The code sets provided an update to the Official ICD-9-CM Guidelines for Coding and Reporting in place at the time, and included additional codes for new procedures and diagnoses. The 2009 final rule established October 1, 2013 as the deadline for compliance with the new code sets.  The newly issued final rule delays the compliance date until October 1, 2014.

Standard Identifiers

The final rule adopts two standard identifiers for use in Health Insurance Portability and Affordability Act of 1996 (HIPAA) standard transactions.  The HPID is a standard unique identifier for health plans.  The rule will require all covered entities to use HPIDs when the covered entity identifies a health plan in a covered transaction. The rule also adopts a data element as an other entity identifier (OEID).  OEIDs will be used as identifiers for entities that are not health plans, health care providers or individuals. CMS anticipates that these changes will simply paperwork for providers and estimates that the changes will save up to $6 billion over ten years. This regulation will take effect 60 days after publication in the Federal Register, which is scheduled for September 5, 2012.