Pulse check: Are you on track for ICD-10?

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Healthcare organizations have only 15 months left to implement ICD-10 but study after study indicates that the code set conversion isn't on their radar.

Hospital ICD-10 implementation efforts are either non-existent or still in their infancy, according to a recent analysis by the American Health Information Management Association. Physician practices are no better off: Only 4.8 percent of more than 1,200 responding practices indicated that they had made "significant" progress in their ICD-10 implementation efforts, according to a Medical Group Management Association study released in June.

A June analysis on ICD-10 readiness found that 33 percent of the 500 physician practices surveyed have yet to even start the transition from ICD-9 to ICD-10, according to Navicure, a medical claims clearinghouse for physician practices. Many of those surveyed complained they don't have enough time, staff or training resources to transition to the new code set.

And this week's eHealth Initiative survey of 281 hospitals, healthcare systems and physician practices reveals probable reasons why organizations aren't in a hurry to take on this massive initiative. They say they expect to encounter significant barriers, challenges and revenue losses with implementation.

Considering the costs involved and the looming Oct. 1, 2014 compliance date, you'd think that ICD-10 would have been a major focus of this year's Healthcare Financial Management Association's annual conference. Although the topic came up in a few break-out sessions, it paled in comparison to the discussions of pricing transparency, mergers, and healthcare reform.

Clearly organizations aren't taking advantage of the additional year they were given to get ready for the code set conversion. And if you are still holding out hope that the Centers for Medicare & Medicaid (CMS) will once again delay the implementation date, think again. Officials say they will hold firm to the Oct. 1, 2014 date.

That means the clock is ticking and regardless how painful and difficult the transition may be, if you haven't started your ICD-10 preparations, you better get moving. One way to think about the transition is to look to the past. Consider the recent testimony that Holly Louie, chair of the Healthcare Billing and Management Association's (HBMA) ICD-10/5010 committee, gave to the National Committee on Vital and Health Statistics subcommittee, about the transition to HIPAA 5010.

"HBMA believes that we must learn from the mistakes that were made in transitioning from 4010 to 5010, and undertake the transition from ICD-9 CM to ICD-10 CM in a way that demonstrates we learned those lessons," she said. Otherwise, Louie said that "the economic stability of America's healthcare reimbursement system will be at risk and could be severely compromised, affecting provider financial viability and patients' access to care."

HBMA outlined several recommendations to ensure a smoother transition to ICD-10, including:

  • End-to-end testing by all payers;
  • A call to CMS to establish benchmarks to make sure all organizations are ready for the transition;
  • An industry-wide realization that there is no one product that will solve the problem; 
  • Adequate training;
  • Publication of payer policies by Oct. 1, 2013 so organizations have time to educate, train and conduct data analysis; and
  • Assurance that all payers are fully 5010 compliant by January 1, 2014 in order to be ICD-10 ready on Oct. 1, 2014.

So if you are among the many organizations that need to quickly come up to speed on ICD-10 implementation, don't panic. There are several resources available to get you started. CMS has step-by- step guides, checklists and timelines for small and medium practices, large provider practices, small hospitals and payers; The American Medical Association offers a checklist  and readiness test guidelines and the Massachusetts Medical Society has an ICD-10 readiness video series that provides lessons learned from current ICD-10 conversion projects.

Where are you in your ICD-10 transition efforts? Let us know the challenges you are facing and the lessons you've learned. - Ilene (@FierceHealth)