Don't let ICD-10 turn into

Ask any hospital CIO to name their most challenging 2014 initiatives, and the transition to ICD-10 is almost certain to be at or near the top of their list. While physician practices clearly have been the most vocal about their displeasure with the mandatory switch from ICD-9--set to go into effect on Oct. 1, 2014--their hospital system brethren haven't been shy about their concerns, either.

With that in mind, last week's news that the Centers for Medicare & Medicaid Services may be open to ICD-10 testing is a (potential) breath of fresh air for the industry. All indications to date about the transition--despite a smattering of success stories here and there--are that it won't be a smooth one; providers need all the guidance they can get.

According to Robert Tennant, a senior policy adviser at the Medical Group Management Association who spoke with MedPage Today, the impetus for the change in heart was the lack of sufficient testing performed prior to launching, a debacle that continues to make headlines more than a month after the site's go-live date. Last week, CMS CIO Tony Trenkle announced his resignation to take a private sector job, and while it's unclear whether or not Trenkle was asked to step down, someone's head was bound to roll.

Over the summer, CMS officials were adamant that there would be no external ICD-10 testing. Cathy Carter, director of the business application management group for CMS' Office of Information Services, said in June that there was never any plan to test health providers "all the way through," addressing questions raised by a CMS announcement released in May. Carter called the process currently in place "rigorous" and "sufficient," adding that there's no money or time to do anything else.

A little more than a month later, MGMA President and CEO Susan Turney said she was "extremely concerned" about such a position in a letter to U.S. Department of Health & Human Services Secretary Kathleen Sebelius. Turney said that such testing could help to avoid a potential "catastrophic back-log of Medicare claims" after the compliance date's passing. "Failure to do so," she added, "could result in significant cash flow disruption for physicians and their practices, and serious access to care issues for Medicare patients."

At the Healthcare Information and Management Systems Society's annual meeting in New Orleans last March, Intermountain Healthcare CIO Marc Probst told me that he thought ICD-10 would be particularly grueling, especially considering the overlap with other mandates, such as Meaningful Use.

"ICD-10 is massive," Probst said. "It's a lot of effort and a lot of risk."

If I were a betting man, I'd wager that CMS officials have no desire to experience déjà vu all over again, especially on the one-year anniversary of perhaps its most high-profile disaster. - Dan @FierceHealthIT