Stakeholders Concerned About ICD-10 Implementation, Survey Finds

June 27, 2014 in News

Although many health care organizations say they will be ready to begin ICD-10 testing this year, there is widespread concern about ICD-10′s effect on workflow, productivity and revenue, according to a survey released Thursday by the American Health Information Management Association, transactions processing management and testing vendor Edifecs and the eHealth Initiative, Health Data Management reports (Slabodkin, Health Data Management, 6/27).

Background on ICD-10

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

In April, President Obama signed into law legislation (HR 4302) that pushed back the ICD-10 compliance date until at least October 2015.

In May, CMS confirmed that HHS plans to soon release an interim final rule that will set the new ICD-10 compliance deadline as Oct. 1, 2015 (iHealthBeat, 6/12).

Survey Details

For the survey, researchers polled a variety of industry stakeholders between May and June on the expected effect of the transition to ICD-10 code sets (Edifecs release, 6/26). The survey included 349 respondents, including:

  • 101 clinics or physician practices; and
  • 115 acute care hospitals or integrated health care delivery systems.

Findings on Readiness

The survey showed that respondents’ readiness to begin ICD-10 end-to-end testing varied. It found:

  • 27% of respondents said they were ready for testing in the third quarter of 2014;
  • 14% said they expect to be ready in the fourth quarter of 2014;
  • Nearly 12% expected to begin testing in the first quarter of 2015;
  • About 10% expected to be ready in the second quarter of 2015;
  • 2.5% expected to be ready by the third quarter of 2015; and
  • Slightly more than 10% reported no plans to conduct such testing.

Of those without testing plans, which primarily included physician clinics and practices:

  • 41% said they did not know how to conduct testing;
  • 14% said testing was too costly;
  • 14% said testing was unnecessary; and
  • 6% said their business partners refused to perform testing with them (Health Data Management, 6/27).

Overall, 45% of respondents said they were unsure if their business partners would be ready to begin ICD-10 testing.

However, the survey found that 68% of respondents said they planned to use the additional time before implementation to train more staff, while 31% plan to hire more coders to help with the transition (Edifecs release, 6/26).

Findings on Implementation Concerns

Meanwhile, many respondents raised concerns about integrating ICD-10 codes and their health IT infrastructure, including:

  • 45% who raised concerns about accounting and billing systems;
  • 39% with concerns about electronic health record systems;
  • 37% with concerns analytics software; and
  • 33% with concerns about health information exchange.

Respondents also expressed concerns about ICD-10′s effect on revenue. The survey found that:

  • 38% of respondents projected revenue to decrease;
  • 14% of respondents projected a neutral effect on revenue; and
  • 6% of respondents projected revenue to increase.

Overall, respondents thought ICD-10 implementation would make several common activities more difficult in the short-term, including:

  • Adjudicating reimbursement issues; and
  • Documenting patient encounters.

However, respondents thought ICD-10 implementation would have certain long-term benefits, including:

  • Enhancing research;
  • Improving claims accuracy;
  • Managing population health; and
  • Measuring performance and quality (Health Data Management, 6/27).
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