• CMS Final Rule Published: ICD-10 and HPID


    ICD-10 Compliance Date Set for October 1, 2014

    On August 24, 2012, the Department of Health and Human Services (HHS) issued a Final Rule that delays the compliance date for the new ICD-10 diagnosis and procedure codes until October 1, 2014.

    The Final Rule, published in the Federal Register on September 5, 2012 and effective November 5, 2012, is a one year delay from the previous compliance date of October 1, 2013. In the meantime, home health providers must use a valid ICD-9 code on all claims.

    The new code sets, known as the International Classification of Diseases, 10th Edition diagnosis and procedure codes, will include some 87,000 codes for new procedures and diagnoses that officials say will boost the quality of information available for quality improvement and payment purposes.

    This Final Rule seeks to save up to $6 billion by adopting the standard for a national unique health plan identifier (HPID) and establishes requirements for implementation of the HPID. Currently, when a healthcare provider bills a health plan, that plan may use a wide range of different identifiers that do not have a standard format. As a result, providers often have trouble with misrouting, needless rejections, and difficulty determining patient eligibility. The new HPID is supposed to greatly simplify the process.

    In addition, it adopts a data element that will serve as an other entity identifier (OEID), or an identifier for entities that are not health plans, health care providers, or individuals, but that need to be identified in standard transactions.