I 
114TH CONGRESS 
1ST SESSION H. R. 2247 
To require the Secretary of Health and Human Services to provide for 
transparent testing to assess the transition under the Medicare fee- 
for-service claims processing system from the ICD–9 to the ICD–10 
standard, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 12, 2015 
Mrs. BLACK (for herself and Mr. HARRIS) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committee on Ways and Means, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To require the Secretary of Health and Human Services 
to provide for transparent testing to assess the transition 
under the Medicare fee-for-service claims processing sys-
tem from the ICD–9 to the ICD–10 standard, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Increasing Clarity for 
Doctors by Transitioning Effectively Now Act’’ or the 
‘‘ICD-TEN Act’’. 
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SEC. 2. IMPLEMENTATION OF HIPAA CODE SET STAND-
ARDS. 
The Secretary of Health and Human Services shall 
implement, administer, and enforce, in accordance with 
this Act and consistent with section 212 of the Protecting 
Access to Medicare Act of 2014, the regulations issued 
on January 16, 2009 (74 Fed. Reg. 3328) and on Sep-
tember 5, 2012 (77 Fed. Reg. 54664) that provide for 
the replacement of ICD–9 with ICD–10 as a standard for 
code sets under section 1173(c) of the Social Security Act 
(42 U.S.C. 1320d–2(c)) and section 162.1002 of title 45, 
Code of Federal Regulations. 
SEC. 3. COMPREHENSIVE TESTING. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall conduct a comprehensive, end-to- 
end testing process to assess whether the Medicare fee- 
for-service claims processing system based on the ICD– 
10 standard is fully functioning. 
(b) AVAILABILITY.—The Secretary shall make the 
end-to-end testing process available to all providers of 
services and suppliers (as defined under subsections (u) 
and (d), respectively, of section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x) participating in the Medicare 
fee-for-service program under parts A and B of title XVIII 
of such Act (42 U.S.C. 1395c et seq.). 
(c) CERTIFICATION.— 
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(1) IN GENERAL.—Not later than 30 days after 
the date of completion of the end-to-end testing 
process, the Secretary shall submit to Congress a 
certification on whether or not the Medicare fee-for- 
service claims processing system based on the ICD– 
10 standard is fully functioning. 
(2) ADDITIONAL STEPS IN CASE STANDARD IS 
NOT
FULLY
FUNCTIONING.—In the case that the 
Secretary certifies under paragraph (1) that such 
processing system based on the ICD–10 standard is 
not fully functioning, the Secretary shall include in 
the submission to Congress under paragraph (1) ad-
ditional steps that will be taken to achieve a certifi-
cation that such processing system based on such 
standard is fully functioning and the anticipated 
timeframe for achieving such certification. 
(d) DEFINITIONS.—In this Act: 
(1) END-TO-END TESTING PROCESS.—The term 
‘‘end-to-end testing process’’ means an process de-
signed to demonstrate that— 
(A) submission of claims to the Secretary 
with ICD–10 codes and the receipt of a remit-
tance advice can be accomplished on a routine 
basis at high volume levels; 
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(B) any software changes made to support 
the ICD–10 standard result in appropriately 
adjudicated claims; 
(C) accurate remittance advices are pro-
duced; and 
(D) all phases of the implementation of the 
ICD–10 transition are operable. 
(2) FULLY
FUNCTIONING.—The term ‘‘fully 
functioning’’ means, with respect to the period of the 
end-to-end testing process of the Medicare fee-for- 
service claims processing system based on the ICD– 
10 standard, that the percentage of claims accepted 
under such system so based during such period is 
equal to or greater than the percentage of claims ac-
cepted during the calendar year previous to such pe-
riod, based on the ICD–9 standard. 
SEC. 4. IMPLEMENTATION PERIOD. 
(a) IN GENERAL.—The implementation period during 
which the transition to ICD–10 standards shall be made 
shall begin on October 1, 2015, and end on the date that 
is 18 months after the date on which a certification is 
made under section 2(c) that the Medicare-fee-for service 
claims processing system based on the ICD–10 standard 
is fully functioning. 
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(b) SAFE HARBOR.—During the implementation pe-
riod described in subsection (a), no claim submitted for 
payment under title XVIII of the Social Security Act by 
a health care provider pursuant to the ICD–10 standard 
medical data code sets shall be denied due solely to the 
use of an unspecified or inaccurate subcode. 
(c) ASSISTANCE.—During the implementation period 
described in subsection (a), the Secretary shall take af-
firmative steps to assist health care providers subject to 
section 1173(c) of the Social Security Act (42 U.S.C. 
1320d–2(c)) and section 162.1002 of title 45, Code of 
Federal Regulations, in identifying appropriate ICD–10 
subcodes. 
Æ 
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