Poor provider ICD-10 prep threatens other healthcare stakeholders

The Workgroup for Electronic Data Interchange (WEDI) warns that many healthcare organizations have not taken advantage of the one-year delay for implementation of ICD-10 and calls uncertainty about further delay the biggest obstacle to readiness.

"Unless all industry segments take the initiative to make a dedicated effort and move forward with their implementation work, there will be significant disruption on Oct. 1, 2015," Devin Jopp, president and CEO of WEDI, says in a letter to Health and Human Services Secretary Sylvia Mathews Burwell. The letter includes the results of the organization's latest survey on the transition to ICD-10.

WEDI surveyed 1,174 providers, vendors and health plans, finding more than half pointing to the possibility of further delays as the biggest impediment to implanting the new code set.

Among vendors who have started product development, more than one-third are finished, and two-fifths are at least three-quarters done. But the numbers are similar to WEDI's August 2014 survey, indicating little progress has been made since. About 60 percent said their products are available or that they have started customer testing.

Among providers, only 25 percent had begun external testing and few had completed it. This was down from about 35 percent in the August 2014 survey.

More than 50 percent of health plans have begun external testing and a few have completed it, a slight improvement from the August poll.

Many providers who did not take advantage of the extra time afforded by the delay are falling further behind, Jim Daley, former WEDI chairman and ICD-10 Workgroup co-chair, says in an announcement.

The delay last year came as part of legislation related to the Sustainable Growth Rate (SGR) formula. The SGR bill the House has sent to the Senate did not include another delay for ICD-10. Members of the House have opposed any further delay, saying it would be costly and time-consuming.

However, the American Medical Association and 99 state and specialty societies have voiced concerns with plans for the transition, citing insufficient end-to-end testing and inadequate contingency plans should failures occur.

Going into the Oct. 1 deadline, providers need to understand the trends from their pended claims for the previous 12 months in order to catch problems quickly, according to Pam Jodock, HIMSS senior director of health business solutions.

To learn more:
- read the letter (.pdf)
- here's the announcement