In a Feb. 24 blog post, Andy Slavitt, Centers for Medicare & Medicaid Services (CMS) Acting Administrator, reflected on the lessons learned from the healthcare industry’s conversion to the ICD-10 coding set last fall.
For many patient care organizations nationwide, there was much concern leading up to the ICD-10 implementation deadline of Oct. 1, 2015. Slavitt himself noted that it was being compared to Y2K, a transition with the potential to create chaos in the healthcare system. But for many providers, the dreaded implementation wasn’t so bad after all.
As such, Slavitt pointed to the transition as an overall success. He wrote, “The ICD-10 implementation had all the hallmarks of how CMS could drive a successful implementation and aim for excellence.” The approach that CMS took which the agency says as “become its doctrine for getting things done,” had four major elements, per Slavitt: be customer focused, be highly collaborative, be responsible and accountable, and be driven by metrics.
CMS specifically noted that in the first month of implementation, it received approximately 1,000 inquiries and responded to 100 percent of them within three business days. To this end, one month following the Oct. 1, 2015 implementation date, CMS reported that claims were processing normally, with 10 percent of claims being rejected and only .09 percent rejected due to invalid ICD-10 codes.
In Slavitt’s Feb. 24 blog post, he gave an updated version of the data using 2015 Q4 information. Indeed, total claims rejected were very much in line with CMS’ historical baseline before the ICD-10 transition— 2 percent of total claims submitted were rejected, the same amount as pre-ICD-10. What’s more, the total number of ICD-9 and ICD-10 claims that were rejected each amounted to 0.17 percent, while the total number of claims denied was 10 percent of all processed.
Slavitt wrote, “For thousands of physicians and other clinicians around the country, the change to ICD-10 was a big undertaking, requiring time, planning, and a period of adjustment. But on October 1, proper execution and good implementation made all the difference. On the big day, the ICD-10 Coordination Center was packed, and the CMS teams and our partners were geared up and ready to make sure that any burden on physicians could be minimized and concerns quickly addressed.”
He continued, “With preparation, planning, a focus on the customer, collaboration, clear accountability, and metrics, the dire Y2K fears didn’t come to pass. Instead, ICD-10 became like what actually occurred on Y2K, an implementation and transition most people never heard about.” He added, “With good implementations, we never declare victory and are still at the ready to continually improve.”