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WEDI: Physician Practices Remain Uncertain About ICD-10

August 4, 2015
by Rajiv Leventhal
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Nearly one-quarter of physician practice respondents said they will not be ready by the October 1, 2015 ICD-10 implementation deadline and another one-quarter were unsure of their level of readiness, according to the most recent ICD-10 Industry Readiness Survey from the Reston, Va.-based Workgroup for Electronic Data Interchange (WEDI).

In its March 31 letter to the Department of Health and Human Services (HHS), WEDI reported concern with the current level of industry preparedness noting that many organizations did not take full advantage of the additional time afforded by the one-year delay. What's more, WEDI has strongly encouraged the department to continue to leverage its communication channels to promote the need for compliance because of the impact that non-compliance could have on the industry.

"Without a dedicated and aggressive effort to complete implementation activities in the time remaining, this lack of readiness may lead to disruption in claims processing," said Jim Daley, WEDI past-chair and ICD-10 Workgroup co-chair, following the organization's most recent survey results from June.

Highlights from the latest survey—which consisted of 621 respondents, of which more than 70 percent were providers—include:         

  • Physician practice testing and readiness: Only about 20 percent of physician practices have started or completed external testing and less than 50 percent responded that they were ready or would be ready for Oct. 1.
  • Hospital/health system testing and readiness: Almost 75 percent of hospitals and health systems have started or completed external testing. Additionally, nearly 90 percent responded that they were ready or would be ready by the compliance date, while a few were unsure if they would be ready.
  • Health plan testing and readiness: Nearly 75 percent of health plans have begun or completed external testing. 40 percent responded that they were already prepared and the remaining 60 percent said they would be ready by October 1.  
  • Vendor product development and availability: 75 percent of vendor respondents have fully completed product development and no one responded that their products would not be ready by the compliance date. 

For what it's worth, a recent survey from the eHealth Initiative and the American Health Information Management Association (AHIMA) also found that level of readiness differed when broken down into hospitals and physician practices. Most hospitals (85 percent) have trained their staffs on using ICD-10, compared with 41 percent of physician practices. Sixty-four percent of hospitals have budgeted for time and costs associated with the transition, while just 19 percent of practices have done the same, according to that survey.

WEDI recommendations to HHS included the following:

  • HHS should expeditiously provide full transparency regarding the readiness of individual Medicaid agencies by state.
  • The recently-announced Ombudsman position should be appointed as soon as possible and WEDI strongly urges CMS to not wait until the compliance deadline to complete this appointment.
  • The go-live ICD-10 support plan should include leveraging WEDI’s and CMS’ implementation support program, which already serves as the central source for collecting ICD-10 industry issues and solutions.
  • Additional outreach is needed in order to help providers with complying with most recent local coverage determination codes (LCDs).

“It is critical to closely monitor industry progress and testing as we approach the compliance date to gauge what might occur on Oct. 1, 2015,” said Jean P. Narcisi, chair of WEDI. “In light of our most recent findings, we are hopeful that industry leaders take the necessary steps to help ensure that the transition to ICD-10 is completed with minimal disruption to the healthcare industry."

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I agree physicians are uncertain about ICD-10, they are confused about ICD-10 coding because some of them are taking early retirements. http://bit.ly/1ElsUg3

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