Providers May Need Four Years to Implement ICD-10

Industry experts have repeatedly said that ICD-10 implementation must begin immediately in order for hospitals, health plans, and vendors to meet the October 1, 2013 compliance deadline. But now there is detailed evidence to prove it.

On July 20, the North Carolina Healthcare Information and Communications Alliance, Inc., (NCHICA) and The Workgroup for Electronic Data Interchange (WEDI) released a timeline that quantifies each ICD-10 preparation task in terms of the number of days it will take to complete.

NCHICA and WEDI estimate it will take providers nearly 1,286 work days to implement ICD-10. For vendors, it will take nearly 1,521 work days to complete. And the clock is ticking.

"The NCHICA-WEDI timeline shows graphically that the full time from now to October 2013 will be required to successfully meet the compliance deadline. We cannot continue to delay this effort," said Holt Anderson, executive director of NCHICA in a press release.

For providers, the figure takes into account 256 days to organize the implementation effort. The timeline also outlines 36 months for identifying process improvements (e.g., how hospitals intend to use more specific data to target education or treatment for certain patient populations), 14 months for internal system design/development, 12 months for internal testing, 12 months for vendor code deployment, and 10 months for external testing.

Although the numbers may sound daunting, the writing has definitely been on the wall since CMS' January 16, 2009 publication of the ICD-10 final rule. Hospitals should already be well on their way toward planning for the change.

Hospitals need to realize that adopting ICD-10 isn't a choice and that there won't be any extension or contingency period in which to do so, says Stanley Nachimson, principal of Nachimson Advisors in Reisterstown, MD, and director of the NCHICA and WEDI timeline project.

Failing to comply by the 2013 deadline or to perform adequate internal and external testing could result in delayed or denied reimbursement, Nachimson says, adding that certain delays and problems will be unavoidable. "There may be a period of time where claims are slowed down while everybody gets used to the coding and understands it," he says.

These delays are something that nobody wants to think about right now, Nachimson says. "Hospitals have such thin margins these days. Even a 1% interruption in their cash flow may be very difficult to manage," he adds.