As 2014 begins, ICD-10 deadline looms

Many are likely waiting on IT vendors

As the new year gets off to a start, the latest findings for ICD-10 remain stark. With an October 1 deadline for conversion of the medical coding system from ICD-9 to ICD-10, some 80 percent of participants have not begun testing, and only about half have undergone the initial step of conducting an impact assessment, according to the Workgroup for Electronic Data Interchange survey published in mid-December.

Many of those are likely waiting on IT vendors, 40 percent of whom said their products won't be ready before 2014, while 20 percent are halfway or even less through upgrading their software for ICD-10. That last bit is where we saw things slip, from 50 percent of technology makers in WEDI’s February survey saying they would be ready by now.

So much concern about readiness triggered discussions and suggestions such as another delay, an enforcement-free period of six months, the speculation that CIOs might be ready but CMS would not, and plenty of talk about CMS’ apparent unwillingness to conduct end-to-end testing — the latter lending itself to cries that ICD-10 would unfold perhaps as messily as HealthCare.gov did.

All of this is not to overlook the bright spots of ICD-10 progress.

Sutter Health revealed intentions to go live early with ICD-10 come May 31, 2014, the culmination of more than three years’ work, thereby giving doctors five months to use ICD-10 before the compliance deadline, Sutter’s ICD-10 program director Danielle Reno said.

“We won’t be submitting claims to payers in ICD-10,” Reno explained at the AHIMA convention, “but we will turn it on and physicians will be able to use it.”

But another frontrunner pilot program encountered results that were nothing short of “scary,” according to Holt Anderson, executive director of the North Carolina Healthcare Information & Communications Alliance.

Early on, NCHICA hand-picked “some of the best of the best” coders from more than 300 participating member organizations and among 20 scenarios dual-coded in ICD-9 and ICD-10, only 55 percent were accurate, at best, Holt explained at the annual MGMA conference. The second wave of the pilot saw a 63 percent accuracy rate. A peer review found that even some of the selected coders were not using ICD-9 correctly, let alone ICD-10. And NCHICA is the organization that works with WEDI to chart recommended timelines for ICD-10.

WEDI celebrated the year-end holidays by unwrapping a new collaboration with the Centers for Medicare and Medicaid services, dubbed the ICD-10 Implementation Success Initiative, to collate partners in support of the transition with resources including a public searchable ICD-10 Issue Reporting System database. 

So payers and providers are about where they were last year at this time, meaning they need to focus on training and education, payer collaboration, cross-mapping solutions, vendor readiness, systems remediation, as well as dual coding.

“The lessons learned show that if you can even do a little bit of dual coding, even within the education modules, that is beneficial,” said Christine Armstrong, principal of Deloitte’s ICD-10 practice. “Those timelines are moving and you don’t get to control them.”