Hospitals remain ill-prepared for ICD-10

'ICD-10 is equivalent to learning another language,' will require proper training, education
By Erin McCann
10:23 AM

The pace at which hospital administrators, health information professionals and compliance employees are moving toward the ICD-10 transition has elicited concern among industry leaders, according to a new survey that finds some 20 percent of small- and mid-sized hospitals have yet to begin any education or training for what's been billed as one of the biggest shifts U.S. healthcare organizations have ever faced.

The survey, conducted by Health Revenue Assurance Associates, included the responses from more than 120 hospitals and found that nearly half are lagging behind on the Centers for Medicare & Medicaid Services timelines for ICD-10 preparation.
“The shift from ICD-9 to ICD-10 is equivalent to learning another language; it will not be as easy as flipping a switch," said Andrea Clark, chief executive officer of HRAA, in a press statement. "HIM coders must be exposed and then trained on the fundamentals of ICD-10 to ensure that a hospital’s revenue system remains intact and that millions will not be left on the table when the transition takes place.”  
Of the hospitals surveyed:
  • 40 percent have not begun ICD-10 CM training for coding staff;
  • 55 percent have not begun ICD-10-PCS training for coding staff;
  • 47 percent have not begun document improvement education for medical staff;
  • 31 percent do not plan to dual code prior to Oct. 1, 2014.

Added Clark, “Education and training is the technical lock for ICD-10 dual coding. Documentation improvement is the key foundation for dual coding efforts for both inpatient and outpatient encounters. Hospital’s ICD-10 coded data tomorrow is only as good as the documentation provided today. A hospital with a lock and key will open the benefits for dual coding.”

While CMS recommends that hospitals conduct internal and external testing in 2013, the majority of respondents stated that they do not plan to start to dual code accounts until 2014. Twenty five percent plan to start in January 2014; 24 percent plan to start in April 2014; and 13 percent plan to begin in July 2014 or later.

[See also: Hospitals still treading water on ICD-10.]

The Workgroup for Electronic Data Interchange, health IT advisor group to the HHS, has also conducted ICD-10 readiness surveys since 2009, and its 2013 survey echo similar findings — more than 40 percent of healthcare providers have yet to conduct impact assessments, implement business changes and begin external testing.

"Based on the survey results, it is clear the industry is not making the amount of progress that is needed for a smooth transition," wrote Devin Jopp, president and CEO of WEDI, in an April letter to HHS. "Factors that contributed to this slow progress include the change in compliance dates, competing internal priorities and other regulatory mandates."

Moreover, despite the fact that respondents indicated that hospitals are delayed in conducting the proper training and testing, 68 percent of respondents in the HRAA survey indicated that they are planning to submit ICD-10 coded claims to payers for testing prior to the transition.

“We were encouraged by the fact that hospitals plan to work with their payers prior to the transition,” Clark added. “However, it’s important that hospitals understand that it’s critical that both ICD-9 and ICD-10 data needs to be stored during this process. It is imperative that they stay in contact with their vendors – both their encoder and patient accounting systems – to monitor when this function becomes available, as this is precious data that a hospital does not want to lose.”


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