Docs far behind hospitals in ICD-10 implementation

While a majority of hospitals and health systems say they are ready or will be ready for ICD-10 by Oct. 1, many physician practices continue to struggle with implementation.

Less than 50 percent of physician practices responding to a recent Workgroup for Electronic Data Interchange survey said they would be ready for the new code set, compared to 90 percent of hospitals and health systems. WEDI conducted the survey in June, which included 621 respondents, according to an announcement.

In addition, only about 20 percent of physicians practices that responded to the survey said they have started or completed external testing. Those numbers are "cause for concern," according to WEDI.

"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," Jim Daley, WEDI past-chair and ICD-10 Workgroup co-chair, said in a statement.

When it comes to the transition, health systems must ensure the right tools are in the hands of those who need them most, according to Bill Reid, senior vice president of product management and partners at SCI Solutions. "Hospitals risk unsuccessful transitions if physician offices in their communities aren't ready," Reid wrote recently at

In the wake of the survey's findings, WEDI wrote to Health and Human Services Department Secretary Sylvia Mathews Burwell on the need to leverage all forms of communication to ramp up promotion on the importance of compliance.

WEDI also recommends HHS:

  • Provide transparency of the readiness of Medicaid agencies by state
  • Appoint the new ombudsman position as soon as possible
  • Have addition outreach to help providers comply with local coverage determination codes
  • Leverage all forms of communication to ramp up promotion on the need for compliance

While the deadline for ICD-10 this time seems set in stone, that hasn't stopped industry professionals and lawmakers on Capitol Hill from seeking ways to ease the transition.

For instance, a recent bill, introduced by Reps. Marsha Blackburn (R-Tenn.) and Tom Price (R-Ga.), would require a transition period for ICD-10 by mandating dual coding in ICD-9 and ICD-10 for six months.

In addition, the Centers for Medicare & Medicaid Services introduced measures in conjunction with the American Medical Association that allow for Medicare claims, for the first year of ICD-10 use, to not be denied or audited based solely on the specificity of diagnosis codes, as long as the codes on such claims are from the correct family of codes in the new code set.

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