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Rush to complete prep for ICD-10 conversion expected, WEDI survey shows


By Joseph Conn
Posted: December 20, 2013 - 3:30 pm ET
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Over the next nine months, it's likely there will be a rush by the healthcare industry to complete preparations for compliance with the upcoming conversion to the ICD-10 diagnostic and procedural codes, according to a survey by a healthcare information technology policy group.

The Reston, Va.-based not-for-profit Workgroup for Electronic Data Interchange, which conducted the survey, also announced its partnership with the CMS and other organizations to develop an online national resource to highlight and help solve ICD-10-related problems.

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The ICD-10 Implementation Success Initiative consists of a website and database where people from organizations across the healthcare industry can post issues, get authoritative responses and promote a dialogue linked to problem solving prior to the scheduled Oct. 1, 2014, launch of the complex ICD-10 codes.

The ICD-10 project mirrors one WEDI undertook in 2012 after the national conversion to the Accredited Standards Committee X12 Version 5010 standards for claims transactions, an ICD-10 precursor. That launch sputtered, forcing the CMS to twice roll back its enforcement deadline.

This time, WEDI wants to be “proactive” with ICD-10, said Devin Jopp, WEDI president and CEO. “We want to get a sense of what are the key issues the industry is experiencing,” Jopp said “If everyone is confused about X, let's do some education” and address those problems before Oct. 1. He said the site is open to the public without charge, but registration is required and a security code must be used to prevent spammers from clogging the system.

Issues can be posted anonymously, but WEDI is requesting that posters identify themselves. WEDI and CMS staffers have been assigned to triage the problems posted and provide answers. So problem solvers might want to touch base with the poster of a question or problem to clarify issues, Jopp said. Industry participants who've been assigned ICD-10 responsibilities also may lurk on the site and follow issue threads as they develop without posting.

Meanwhile, the entire healthcare industry is “behind the curve” in its preparedness, according to WEDI's latest survey. The organization, which was officially designated as an adviser to HHS in the Health Insurance Portability and Accountability Act, has been conducting periodic industry surveys on ICD-10 preparations since 2009. Its most recent survey was conducted this past October and had 353 respondents from 196 providers, 98 health plans and 59 vendors.

Highlights of the latest survey show an overwhelming majority—eight out of 10 providers—indicated they would not have their all of their ICD-10-related business changes made, and thus could not begin testing their systems, before Jan. 1, 2014.

More than 20% of vendors surveyed indicated they were either less than or only halfway finished with their ICD-10–related product enhancements and that those preparations won't be ready until 2014. One in four health plans surveyed had not completed their ICD-10 impact assessments, while only about a third of the plans expected to begin or had already begun external testing with other data exchange partners by the end of 2013.

A six-page combined letter and summary report of the survey was sent to Robert Tagalicod, director of the Office of E-Health Standards and Services at the CMS on Dec. 13.

“I would completely agree with the assessment WEDI has made of the survey results,” said Stanley Nachimson, a Baltimore-area health IT consultant and ICD-10 specialist. “We've run out of time for providers to do a really thorough ICD-10 implementation.” So instead, “they'll now have to focus on three areas—clinical documentation improvement on their highest-revenue diagnoses, work with vendors to see that software is installed as quickly as possible, and they're going to have to start testing as best as they can as quickly as they can.”

A wild card in the testing mix is the CMS. Its Medicare Administrative Contractors—private-sector firms that do claims processing on CMS's behalf—will not be performing full, end-to-end testing of the electronic claims process with providers and claims clearinghouses, despite repeated requests from other healthcare industry participants to do so. The CMS doesn't plan to require its contractors to do it.

“The Medicare folks said they are comfortable with the internal testing the MACs have done at this point,” Nachimson said. Meanwhile, the feds insist the Oct. 1 launch date of ICD-10 won't change, he said. All of which adds to his growing sense of pessimism about the transition.

“My own personal view is, I see major problems looming on the horizon for Oct. 1,” Nachimson said. “I just don't see the progress on the plan and provider side. There are too many providers who haven't done preparatory work and not enough information is being published from the plans.”

Follow Joseph Conn on Twitter: @MHJConn


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