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MGMA: As ICD-10 Compliance Date Approaches, Industry Still Far Behind

February 4, 2014
by Gabriel Perna
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Less than 10 percent of physician practices are ready for the switch to the ICD-10 code-set, according to a new survey from the Englewood, Colo.-based Medical Group Management Association (MGMA).

The deadline for the switch to the ICD-10 code-set is Oct. 1, as mandated by the Centers for Medicare & Medicaid Services (CMS). According to research done by MGMA, which includes responses from more than 570 medical groups where more than 21,000 physicians practice, only a small percentage of the industry is ready.

Along with the lass than 10 percent that are ready for ICD-10, MGMA's research revealed that most practices need a software upgrade. More than 80 percent of respondents indicated that their practice management software would require replacement or upgrading in order to accommodate ICD-10 diagnosis codes, this is up from 73.2 percent in June, when MGMA last conducted this survey. In addition, 81.8 percent say their EHR needs to be replaced or upgraded, a jump from 65.3 percent in June.

Moreover, 41 percent say the cost to upgrade or replace their practice management system software will be covered by their vendor, and half say their vendor will cover the cost of their EHR replacement or upgrade. On average, the cost to upgrade will be $11,500 per full-time physician for the practice management upgrade or replacement and $12,885 for the EHR.

Testing too is behind. Nearly 60 percent say they have not heard from their health plans on testing for ICD-10. Only 5.4 percent reported that they have begun testing with their major health plans.

“The critical coordination that must take place between practices and their software vendor, clearinghouse and health plan partners is simply not happening at the pace required for a seamless implementation. Very simply, ICD-10 is behind schedule,” Susan L. Turney, M.D., MGMA president and chief executive officer, said in a statement. “MGMA continues to advocate on behalf of members and provides tools and resources to help practice executives make the transition to ICD-10 more cost effective and less disruptive to their organizations.”

MGMA once again urged CMS to initiate end-to-end testing with physician practices, something it brought up in July. It also asked CMS to release all Medicare and Medicaid payment edits and advised commercial health plans to do the same.

“The publication of testing schedules, payment policies and readiness levels are all necessary actions for both CMS and practice trading partners in the private sector. Without this preparation, there will be significant increases in cash flow disruptions to practices that will affect the ability to treat patients," Turney added.

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