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As ICD-10 Deadline Looms, Healthcare Providers Fret

John Commins, for HealthLeaders Media, February 7, 2014

Healthcare providers, payers, the government, and other players in the ICD-10 changeover are not working in a cohesive and coordinated fashion and won't be ready for the transition in eight months, says an MGMA policy expert.

The looming Oct. 1 implementation for ICD-10 has healthcare providers antsy about a potentially rocky transition to the new diagnostic code set in the midst of other fundamental and profound changes to the healthcare sector.

A Medical Group Management Association survey of more than 570 practices representing more than 21,000 physicians finds that less than 10% of them had made significant progress when ranking their overall readiness for Oct. 1, up from 4.7% in June, 2013.

MGMA Senior Policy Advisor Robert Tennant says providers, payers, the government, and other players in the ICD-10 movement are not working in a cohesive and coordinated fashion.

"ICD-10 is like a cascade. Things can't happen until other things happen," Tennant says. "What we are finding through research and discussions with our members and industry [is that] the pieces aren't coming together as quickly as the government had expected them to. That includes software vendors, clearinghouses, [and] health plans. Nobody seems to be out front and leading the pack, and that includes the government."

He notes, for example, that there are only eight months until the implementation date and Medicare has not yet released its payment edits. "They've not yet begun to test with providers and even when they do so in March they are only going to do front-end testing. They aren't going to test the claim from start to finish. This is a recipe for disaster if all of these pieces don't come together," he says.

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1 comments on "As ICD-10 Deadline Looms, Providers Fret"


Harry Goldsmith, DPM (2/7/2014 at 11:10 AM)
2014 has been set up as a "perfect storm" with demands for change and increased regulation above and beyond, in my opinion, what providers - whether in solo practice, small groups, or large groups - will be able to efficiently handle. ICD-10, indeed, will be implemented on October 1, 2014. The question that should be asked is, why does the United State feel it is critical to require the 6 and 7 character for many of the coding? I would suggest - and I know several medical organizations have also commented to this point - that CMS/CDC suspend the use of the 6 and 7 characters for x years allowing providers to transition smoothly from ICD-9 to ICD-10. The 6 and 7 characters represent redundant information already available in CPT coding and the medical record. The burdens associated with applying the 6 and 7 characters (when required) are many including documentation (charge ticket/superbill development and use), the bogging down of workflow efficiencies from provider to coder/biller, as well as adding to the complexity of the business-side of medicine. No other country added additional characters for the primary purpose of 3rd party datamining. CMS/CDC should "toggle off" the need for these extra characters that have nothing to do with altering immediate and practical treatment outcomes.