Last year, we discussed the October 2013 ICD-10 Readiness Survey by the Workgroup for Electronic Data Interchange (WEDI) and found that the healthcare industry was not prepared for ICD-10 compliance. Now, the June 2015 ICD-10 Industry Readiness Survey by WEDI gives us a slightly different picture. The survey says that while much of the healthcare industry is nearing ICD-10 compliance, nearly one-quarter of physician practices say they won’t be ready by October 1, 2015 and another one-quarter remain unsure about their preparedness. This lack of readiness may cause disruption in claims processing and negatively impact medical billing after the ICD-10 implementation.
There were 621 participants in the survey comprising 453 providers, 72 vendors and 96 health plans. The significant findings of the survey are as follows:
- Only 20 percent of physician practices have begun or finished external testing and less than 50 percent said they were ready or would be ready to embrace the new medical coding system to be implemented on October 1, 2015.
- Around 75 percent of hospitals and health systems have begun or finished external testing and nearly 90 percent said they were ready or would be ready by the ICD-10 compliance date. A few were not sure about whether they would be ready by that date.
- Nearly 75 percent of health plans have started or finished external testing. When 40 percent said they were already prepared, 60 percent responded they would be ready by the compliance date.
- Almost 75 percent of vendors have fully completed product development and everyone responded that their products would be ready by the compliance date.
Though hospitals, health plans and vendors are heading towards ICD-10 readiness, physicians are lagging behind considerably and this is a great cause for concern. According to the WEDI, it is important to closely monitor industry progress and testing while approaching the compliance date. Industry leaders should take appropriate steps to ensure smooth transition to ICD-10 with minimal disruption to the healthcare industry. WEDI recommendations to the United States Department of Health and Human Services (HHS) are as follows.
- HHS should provide full transparency quickly when it comes to the readiness of individual Medicaid agencies by state.
- The recently announced Ombudsman position should be appointed at the earliest without waiting until the compliance date.
- The go-live ICD-10 support plan should include leveraging WEDI’s and CMS’ implementation support program
- It requires additional outreach to help providers comply with the latest local coverage determination codes (LCDs).
Physician practices should take the necessary steps to achieve ICD-10 readiness by the compliance date. They should review the clinical documentation, identify the gaps and resolve the differences as quickly as possible. To ease the transition, a feasible alternative is to obtain the service of a billing and coding company. Even so, physicians should work closely with their partnering outsourcing firms to ensure that all necessary documentation is up-to-date and accurate.