Physician Practices Unprepared for ICD-10 Transition, Study Shows

TOPIC ALERT:

Physician groups are lagging in their readiness to meet the Oct. 1, 2014, compliance deadline for ICD-10, according to research released Thursday by the Medical Group Management Association, Healthcare IT News reports (Manos, Healthcare IT News, 6/13).

Background on ICD-10

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch from ICD-9 to ICD-10 code sets means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

In August 2012, HHS released a final rule that officially delayed the ICD-10 compliance date until Oct. 1, 2014 (iHealthBeat, 6/4).

Research Findings

MGMA's research -- which includes responses from about 1,200 medical groups where 55,000 physicians practice -- found that only 4.8% of responding practices have made significant progress when rating their overall ICD-10 implementation readiness.

According to the research, physician practices' greatest concern is lack of communication and coordination between physician practices and their trading partners -- such as electronic health record vendors and claims clearinghouses (Healthcare IT News, 6/13).

MGMA also found that 55% of respondents reported being "very concerned" about the costs associated with the transition to ICD-10, while 70% were "very concerned" about the loss of clinical productivity after transitioning to ICD-10 code sets (Bowman, FierceHealthIT, 6/13).

The research found that among organizations covering the expense themselves, the average cost for a 10-physician practice to replace or upgrade its EHR system and practice management software to accommodate ICD-10 is $201,690.

In addition, the research found:

  • 88% of respondents are concerned or very concerned about expected clinical documentation changes;
  • Nearly 60% of respondents reported they are "not at all" or "slightly confident" their major health plans will be ready to meet the ICD-10 compliance date;
  • More than 52% of respondents indicated they have not heard from their practice management system vendor about when software upgrades would be available; and
  • Nearly 50% have yet to hear from their EHR vendor about when software upgrades would be available (Healthcare IT News, 6/13).
Stephen Ruehle
Apparently no one who writes these articles has actually studied ICD-10. It is more patient care dollars to software vendors. It is delay and deny on steroids. The ICD-10 Implementation Guide, published by CMS references “failing revenue, delays, denials and rejections” (17) times, “costs and budget limitations” (9) times, with their advice: “increase lines of credit”. ICD-10 increases the number of codes from 15,000 to 150,000. There will be more than 1,800 possible codes for a fractured radius. Why? Centuries of well established, useful medical terminology is thrown out the window when amputations must be designated “detachment”, or tonsillectomy becomes “resections of the tonsil”, etc., etc., etc. It is not science, it is not patient care. It is hours of searching for correct sequences of up to seven separate codes to identify a 1st degree burn. Initial care, no longer means first exam, it also encompasses on-going care. Please get your facts straight before you report!

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