CMS may be open to ICD-10 testing

The Centers for Medicare & Medicaid Services, despite previously proclaiming it would not conduct external ICD-10 testing, may be changing its tune, MedPage Today reports. In the wake of the ongoing HealthCare.gov debacle, Robert Tennant, a senior policy adviser at the Medical Group Management Association (MGMA), told MedPage that CMS was "at least willing to revisit the issue of testing," at an ICD-10 stakeholder collaboration meeting earlier this week.

"They understand that there's been a lot of concern in the industry on their testing," Tennant told MedPage. "You don't test something, and you run the risk. That's absolutely the message we're trying to send."

A successful ICD-10 transition requires, first and foremost, physician understanding the value of using the updated code set. While reimbursement dollars, no doubt, are important, Deb Neville, director of revenue cycle, coding and compliance at Elsevier/MC Strategies, says that too much of a focus on getting paid could prove detrimental to its use.

"If you tie payment into something, people act," Neville told EHRIntelligence.com. "However, it's time for us as an industry to understand that data is going to help us take care of people, the very sick; it's going to help us manage those chronic diseases; it's going to help us take away the risk or some of the risk to patients in the way that their care is provided."

Similarly, Carl Natale, Editor of ICD10Watch, notes in a post to Healthcare IT News that simply telling physicians that more codes = more data, which leads to more efficient care, isn't enough to guarantee success.

"Organizations need to have a plan that uses clinical data and shares it with physicians," Natale says. "They need to know their work makes a difference and see the results."

In addition, Natale offers several other tips for transitioning from ICD-9 to ICD-10. Here are three:

  • Train physicians to be teachers: To ensure physician buy-in, teach them about ICD-10 so they, in turn, can share their knowledge with fellow doctors. "Physicians need to hear from someone who respects their knowledge and time," Natale writes.
  • Minimize effort: Splitting up ICD-10 training for physicians over several sessions works on several levels, according to Natale. In addition to making sure busy doctors have time for training, it also makes such training feel less cumbersome. "No one has enough time," Natale says. "Physicians feel the pressure even more."
  • Inoculate against disruptions: By making sure that physicians understand all of the efforts associated with their training, Natale says that they'll be more appreciative. "They will be more willing to learn," he says.

Coders participating in an ICD-10 test by the Healthcare Information and Management Systems Society (HIMSS) and the Workgroup for Electronic Data Interchange (WEDI) achieved an average accuracy rate of just 63 percent, according to a report released last month. The National Pilot Program was designed to be a collaborative, industrywide effort to help those transitioning to the new coding system by sharing best practices and lessons learned.

To learn more:
- read the MedPage Today article
- here's the EHRIntelligence.com article
- check out the Healthcare IT News post