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S. 972 (113th): Cutting Costly Codes Act of 2013

The Cutting Costly Codes Act would prevent the Department of Health and Human Services (HHS) from changing the version of the International Classification of Diseases (ICD) system that is used by the American medical industry from version 9 to the newer version 10.

Congressman Ted Poe [R-TX2] and Senator Thomas Coburn [R-OK] sponsored identical bills in both houses, citing the growing costs and administrative duties placed on physicians as an impediment to a healthy medical industry. Sen. Coburn stated that while health care providers struggle to navigate the murky waters of health care reform, HHS should halt the implementation of ICD-10.

The bill also calls for the Government Accountability Office (GAO) to study methods to lessen the disruption on health care providers resulting from a replacement of ICD–9. A report on the study must be submitted to Congress six months after the bill is passed.

The ICD, which is maintained by the World Health Organization (WHO), is a health care classification system that helps internationally track, diagnose, and treat health problems. It is used for the WHO’s statistical tracking and resource allocation to member states. ICD-9 was ratified in 1975. ICD-10 was completed in 1992 and entered use in other countries starting in 1994.

The Health Insurance Portability and Accountability (HIPAA) code set is the U.S. method for implementing the ICD. These codes help doctors diagnose patients and insurance companies determine payouts for treatments. ICD-10 would require the U.S. medical industry, from family doctors to insurance companies, to reform the HIPAA codes they use to be in line with ICD-10, an overhaul estimated to cost millions of dollars for large practices. However, the Centers for Medicare and Medicaid Services (CMS), which is the federal agency that administers HIPAA and oversees federal healthcare programs, has estimated that pushbacks can also cost over one billion dollars.

The changeover was originally mandated for 2009, but the date has been repeatedly pushed back. CMS in 2009 originally postponed the deadline to 2013, and Congress voted earlier this year to again delay its implementation for another year to 2015 in response to calls by organizations such as the American Medical Association. The Cutting Costly Codes Act would prevent the implementation of ICD-10 going forward, until further congressional action.

Last updated Sep 22, 2014. View all GovTrack summaries.

The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on May 16, 2013.

Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information.

(The ICD is a health care classification system of diagnostic codes for classifying diseases.)