Report: Health Care Organizations Vary in ICD-10 Readiness

November 6, 2014 in News

While a majority of health care organizations are on track to conduct end-to-end ICD-10 testing prior to the October 2015 compliance date, several smaller organizations appear to be struggling, according to a new report, Health Data Management reports (Slabodkin, Health Data Management, 11/5).

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, 6/27).

Report Details

The report — which was released Tuesday by the American Health Information Management Association and the eHealth Initiative —  was based on a survey conducted between May and June that focused on health care organizations’ readiness for testing and implementation, anticipated effects of implementation and strategic implications (Dimick, Journal of AHIMA, 11/4).

Researchers polled 454 individuals from a variety of health care settings including acute care hospitals, clinics, health care delivery organizations and physician practices (Health Data Management, 11/5).

Report Findings

In the report, AHIMA and eHI wrote that the survey findings suggest there could be “a knowledge gap around ICD-10 implementation and testing for those organizations with fewer resources,” such as clinics and physician practices (Journal of AHIMA, 11/4).

For example, the report showed:

  • 65% of respondents indicated their organization would be prepared to conduct end-to-end testing ahead of the compliance deadline on Oct. 1, 2015;
  • 17% were unsure when their organization might be prepared to begin testing; and
  • 10% said their organization did not have plans to conduct end-to-end testing (Hall, FierceHealthIT, 11/5).

Of the respondents who said their organizations did not have testing plans, 45% were physician practices or clinics and 36% cited a lack of testing knowledge.

Further, the report found that many survey respondents indicated they were unsure if their business partners planned to conduct testing, although larger partners — such as IT vendors, acute care hospitals and clearinghouses — were more likely to make their testing plans known.

In addition, the survey found 35% of respondents felt that their organization’s revenue would decrease during the first year of ICD-10 implementation, while just 6% believed revenue would increase. Many respondents also felt the new ICD-10 coding system would negatively affect coding, documenting patient encounters and adjudicating claims. Such concerns were higher among clinics and physician practices (Health Data Management, 11/5). 

Meanwhile, the survey found that prior to the compliance date:

  • 70% of respondents said their organizations intend to conduct more training and practice to assist staff with ICD-10 implementation;
  • 62% said they were working to enhance integrity of clinical documentation;
  • About 33% expect to address gaps in productivity by contracting with companies that outsource code; and
  • 32% intend to buy computer-assisted coding IT or similar IT tools (Journal of AHIMA, 11/4).

Report Recommendations

The report recommended that, in advance of the ICD-10 compliance deadline, providers:

  • Conduct testing early and frequently at all stages of implementation;
  • Collaborate with peers and other organizations in their area on ICD-10 implementation best practices; and
  • Develop strategies to mitigate ICD-10 implementation risk, such as dual coding (Walsh, Clinical Innovation Technology, 11/5).
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