ICD-10 testing lags among providers

Provider organizations continue to lag behind in testing for the transition to ICD-10, according to a survey unveiled Wednesday by the eHealth Initiative.

Of 271 providers to respond to the survey, conducted in May and June, half said they have conducted test transactions using ICD-10 codes with payers and clearinghouses. Only 34 percent said they have completed internal testing, while 17 percent have completed external testing.

While most respondents intend to ultimately go through with testing, 19 percent still said they have no plans to conduct end-to-end testing. Sixty percent of respondents represented hospitals or health systems, while 18 percent represented clinics or physician practices.

"I would like to see the percentage of small organizations and physician practices that still have not taken any steps toward the transition drop to zero," said Sue Bowman, senior director of coding and policy compliance at the American Health Information Management Association. "We need that to drop to zero because to make this all work on Oct. 1, we really need everyone to be ready. The disruptions are more likely to occur if you are not prepared."

Regarding the impact on revenue, despite the lack of testing that has occurred, 38 percent of respondents said they believe revenue will decrease after implementation, with 78 percent citing an increase in denied claims as the cause. What's more, 80 percent said they believe reduced coding productivity or accuracy will increase costs.

Only 6 percent of respondents said they foresee revenues increasing; 34 percent of respondents said their organization has not conducted a revenue impact assessment.

"Change is disruptive, change is expensive, but it's evolution and it's the way of things," said Karen Blanchette, association director for the Professional Association of Healthcare Office Management. "If we want to be better at what we do, if we want to continue to move forward, then change is going to be a part of that. We have to make the best and smartest decisions about preparation so that the changes seem less disruptive."

A bill introduced June 4 by Rep. Gary Palmer (R-Ala.) seeks to provide a grace period of two years for providers set to make the transition to ICD-10. During the grace period, physicians and other providers would not be "penalized for errors, mistakes and malfunctions relating to the transition." A similar bill introduced in May by Rep. Diane Black (R-Tenn.) would provide an 18-month "transition period" for providers implementing ICD-10.

The Centers for Medicare & Medicaid Services recently announced the results of its second round of testing, completed in April. The agency said 88 percent of test claims were accepted; 81 percent of test claims were accepted during the first round of testing in January.

To learn more:
- check out the survey results (.pdf)

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