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Optimism prevails in poll on ICD-10 preparation


By Joseph Conn
Posted: March 5, 2014 - 1:45 pm ET
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Nearly two out of three ModernHealthcare.com readers participating in an online poll expressed optimism they will be prepared for the national conversion to the ICD-10 codes this fall.

But a third say they are having difficulties with vendors in their ICD-10 readiness efforts and more than a third express doubt they would be able to meet the federally mandated switch to ICD-10 by deadline.

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The poll appeared on Modernhealthcare.com from Feb. 28 through March 4, drawing 121 responses.

ICD-10 optimism prevailed, with a plurality (38%) of respondents selecting, “We're well on our way to compliance and expect to meet the deadline,” while 18% chose, “We are having difficulties with vendors, but expect to meet the deadline.” Another 7% indicated, “We are ready to comply with ICD-10.”

But one in five (20%) respondents selected, “We are having difficulty with vendors and have doubts we can meet the deadline.” And another 14% chose, “We are having no difficulty with vendors, but still anticipate problems meeting the deadline.”

Whether they are optimistic or have doubts they will meet the ICD-10 start date, 38% of respondents indicated their efforts to prepare have been hampered by vendors.

We asked site visitors, “What's your organization's status regarding meeting that (ICD-10) deadline?” and gave them five selections to chose from and an opportunity for an open-ended response.

The survey's five response options didn't quite fit the situations of three respondents. One said, “This organization has not begun the process,” another, “We are having difficulty with payers, but our work … is on track,” and another, “We began training of staff and that is it right now.”

In many respects, the results from this latest poll mirror responses to ICD-10 questions from the broader 24th annual Modern Healthcare Survey of Executive Opinions on Key Information Technology Issues.

In it, 8% of respondents indicated their ICD-10 work was done, 57% listed it as a work in progress, 19% said they would start within 12 months, 11% had not started and 5% said they had not considered it. Asked how confident they were that their organization would be ICD-10 ready by Oct. 1, 36% were highly confident, 40% somewhat confident, 12% unsure, 8% somewhat pessimistic and 4% highly pessimistic.

CMS Administrator Marilyn Tavenner said last week at the Healthcare Information and Management Systems Society convention in Orlando, Fla., “There are no more delays and the system (ICD-10) will go live Oct. 1. Let's face it guys, we've delayed this several times and it's time to move on.”

The situation has been complicated by software developer delays in delivering ICD-10 compliant products to providers. Another challenge is that some providers this year also need to meet Stage 2 meaningful-use criteria of the federal electronic health record incentive payment program. In addition, whether they are in Stage 1 or Stage 2, all hospitals, physicians and other professionals participating in the EHR incentive program this year must upgrade to 2014 Edition tested and certified software, which also is late in coming from some developers.

With less than seven months before the compliance deadline, the size of the percentage of organizations reporting ICD-10 difficulties in the poll is unsurprising to Terrance Govender, director of the healthcare coding and documentation practice at the consulting firm Navigant.

Many organizational leaders believe they had ICD-10 under control, but then they started running into obstacles, and not only vendor troubles. They began realizing they don't have enough IT staff, expertise or an adequate plan, and, “'In spite of making a lot of effort, we're not where we should be,'” Govender said.

“I know CMS has put their hands down and said it's going to happen, but what's going to happen is there is going to be chaos, there are going to be denials (of claims) and a decrease in productivity,” he said. Some of these problems still can be mitigated, Govender said, but they all won't be eliminated.

“I don't believe the entire system will shut down, but I do believe it's going to be a chaotic time,” he said. “I see all of these as the necessary evils to get up to speed on down the line.”

Follow Joseph Conn on Twitter: @MHJConn


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