With the ICD-10 delay, the Centers for Medicare & Medicaid Services has squandered the opportunity to learn from the mistakes made with the 2012 switch in transaction standards, according to Holly Louie, chair of the Healthcare Billing and Management Association's ICD-10 Committee.
She was among the stakeholders who testified Tuesday before the National Committee on Vital and Health Statistics Subcommittee on Standards.
"We have the opportunity, over the next 18 months, to robustly test all of the documentation, coding methodologies, practice management systems, interfaces and adjudication systems affected by this change. In other words, we can have 18 months of end-to-end testing," she told the committee.
But CMS has decided to delay testing until 2015 and some commercial payers have followed suit, delaying testing with trading partners until next summer.
"It certainly begs the question: Were all who [said] they were ready for the October 1, 2014 changeover truly ready?" Louie asked.
Humana's Sidney Hebert, speaking on behalf of America's Health Insurance Plans, said the industry should not rely solely on CMS to ensure industry readiness in 2015, but all collaborate for a smooth transition. Humana recently rated vendor readiness as one of its to top concerns. He urged focus on five areas:
- Provider readiness
- Vendor readiness
- Ongoing support for implementers
- A realistic implementation approach
He then urged CMS to take the lead in those areas.
John Powers, chief administrative information officer at Beth Israel Deaconess Medical Center, urged CMS to focus on administrative simplification. He said his institution breathed a sigh of relief with the delay. It has concerns about coding productivity under ICD-10--its testing has found productivity loss of up to 50 percent--and with clinical documentation.
The market is pushing salaries up for seasoned coders and his institution has lost six – four to much higher salaries, he said.
He cited a need for sophisticated coding software and specialized compliance specialists to oversee the process. A whole market is cropping up in coding improvement, he pointed out.
Speaking for the Workgroup for Electronic Data Interchange, Chairman Jim Daley pointed to its recently released roadmap to limiting the burden caused by the delay.
To learn more:
- find the testimony