Physicians Not Ready for ICD-10, New Survey Says

Nearly 25 percent of physicians’ offices will not be ready when ICD-10 is implemented Oct. 1, and another 25 percent are unsure of their state of readiness, according to a new survey by the Workgroup for Electronic Data Interchange (WEDI), the nation’s leading nonprofit authority on the use of health information technology.

“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.

Highlights from the survey include:

  • Physician practice testing and readiness: Only about 20 percent of physician practices have started or completed external testing and less than 50 percent responded that they were ready or would be ready for Oct. 1. This is cause for concern.
  • Hospital/health system testing and readiness: Almost 75 percent of hospitals and health systems have started or completed external testing. Additionally, nearly 90 percent responded that they were ready or would be ready by the compliance date, while a few were unsure if they would be ready.
  • Health plan testing and readiness: Nearly 75 percent of health plans have begun or completed external testing. 40 percent responded that they were already prepared and the remaining 60 percent said they would be ready by Oct. 1.
  • Vendor product development and availability: 75 percent of vendor respondents have fully completed product development and no one responded that their products would not be ready by the compliance date.

WEDI’s recommendations to the Department of Health and Human Services included:

  • HHS should provide full transparency regarding the readiness of individual Medicaid agencies by state.
  • The recently-announced Ombudsman position should be appointed as soon as possible; WEDI strongly urged the Centers for Medicare and Medicaid Services not to wait until the compliance deadline to complete the appointment.
  • The go-live ICD-10 support plan should include leveraging WEDI’s and CMS’ implementation support program, which already serves as the central source for collecting ICD-10 industry issues and solutions.
  • Additional outreach is needed to help providers with complying with most recent local coverage determination codes.

Robert Tennant, vice chair of the WEDI group and government affairs senior policy adviser for the Medical Group Management Association, said in an article for Medscape Medical News that physicians are struggling so much with the conversion to ICD-10 that many “are at the mercy of their software vendors.” Out-of-date software leaves physicians no way to submit the new codes or test their systems.

“What that tells us in the industry is that we’re looking at potentially a situation, where the light switch is flipped and things don’t work,” Tennant said in the article.

The Medical Association continues to push Congress for workable solutions to this unfunded mandate on medical practices.

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