Hospitals Increase Training, But Issues Remain for ICD-10 Implementation, Survey Says | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Hospitals Increase Training, But Issues Remain for ICD-10 Implementation, Survey Says

October 1, 2013
by Rajiv Leventhal
| Reprints

Exactly one year out from the transition, more small and mid-sized hospitals are taking steps to prepare for the implementation of ICD-9 to ICD-10, but still but lag when it comes to payer preparations, financial modeling, and denial strategies, according to a new survey by Health Revenue Assurance Holdings (HRAA), a Plantation, Fla.-based coding vendor.

While the results showed that hospitals are focusing on employee training, the survey of 200 hospital administrators, hospital health information professionals, and compliance employees also revealed that they are leaving their organizations exposed to massive claims denials when the transition takes effect.

This is because they do not understand what ICD-10 codes will be accepted by the payers as it relates to reimbursement maps and diagnosis-related group (DRG) groupings. Additionally, they are lacking denial strategies and financial models to help them avoid what could be a colossal claims backlog post-transition, the survey said.

The survey is a follow up to industry research conducted by HRAA in April, which revealed more than half of hospitals were not complying with Centers for Medicare and Medicaid Services (CMS) suggestions and were falling behind the curve.

Of the hospitals surveyed:

• 78 percent have begun ICD-10 CM training for coding staff, compared to last quarter’s 60 percent

• 64 percent have begun ICD-10 PCS training for coding staff, compared to last quarter’s 45 percent

• 68 percent have begun document improvement education for medical staff, compared to last quarter’s 53 percent

• 76 percent plan to dual code prior to October 1, 2014, compared to last quarter’s 69 percent

While 71 percent of hospitals plan to submit ICD-10 coded claims to payers prior to October 1, 2014, they are not taking the initiative to understand how their payers are mapping their claims, which leaves them vulnerable to excessive denials and a slowdown in reimbursements.

Eighty-five percent stated that they do not know if their payers are planning to map claims utilizing CMS reimbursement maps to group the claims to DRGs. Internally, less than half (42 percent) stated that they plan to use CMS reimbursement maps to evaluate DRG groupings compared to those based on the ICD-10 grouper.

Get the latest information on ICD10 and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Former Health IT Head in San Diego County Charged with Defrauding Provider out of $800K

The ex-health IT director at North County Health Services, a San Diego County-based healthcare service provider, has been charged with spearheading fraudulent operations that cost the organization $800,000.

Allscripts Touts 1 Billion API Shares in 2017

Officials from Chicago-based health IT vendor Allscripts have attested that the company has reached a new milestone— one billion application programming interface (API) data exchange transactions in 2017.

Dignity Health, CHI Merging to Form New Catholic Health System

Catholic Health Initiatives (CHI), based in Englewood, Colorado, and San Francisco-based Dignity Health officially announced they are merging and have signed a definitive agreement to combine ministries and create a new, nonprofit Catholic health system.

HHS Announces Winning Solutions in Opioid Code-a-Thon

The U.S. Department of Health and Human Services (HHS) hosted this week a first-of-its-kind two-day Code-a-Thon to use data and technology to develop new solutions to address the opioid epidemic.

In GAO Report, More Concern over VA VistA Modernization Project

A recent Government Accountability Office (GAO) report is calling into question the more than $1 billion that has been spent to modernize the Department of Veterans Affairs' (VA) health IT system.

Lawmakers Introduce Legislation Aimed at Improving Medicare ACO Program

U.S. Representatives Peter Welch (D-VT) and Rep. Diane Black (R-TN) have introduced H.R. 4580, the ACO Improvement Act of 2017 that makes changes to the Medicare accountable care organization (ACO) program.