The latest survey of physician readiness for ICD-10 from the Medical Group Management Association should give the industry pause.

Less than 10 percent of 570 responding practices in January have made significant process in overall readiness. And they are worried about six core implementation issues: Overall cost of converting to ICD-10 (92 percent), changes to clinical documentation (97 percent), loss of clinician productivity after implementation (96 percent), loss of coding staff productivity after implementation (94 percent), cost of upgrading or replacing practice software (76 percent) and ability to obtain executive support for the conversion (58 percent).

As of January 2014, 60 percent of respondents did not know when testing with major payers would start, and only 5.4 percent had started testing. Half of respondents had not yet heard from their clearinghouse about testing times and only 8 percent were testing with a clearinghouse. Only 8 percent had begun or ended testing with their electronic health records vendor; and about 10 percent with their practice management vendor.

Physician practice respondents also in large numbers believe the following tasks will be considerably more difficult under ICD-10: document patient encounters, physician and coder selection of appropriate diagnosis codes, include most frequently used diagnosis codes on a superbill, compare new diagnosis data in ICD-10 with previous data using ICD-9, outsource billing and contract with health plans. MGMA calls on the Centers for Medicare and Medicaid Services to take immediate action in these areas:

* Initiating complete end-to-end testing with physician practices and assessing claims through the entire business cycle,

* Releasing all Medicare and Medicaid payment edits and advising commercial insurers to do the same,

* Publishing on an ongoing basis the readiness level of all Medicare contractors and state Medicaid agencies,

* Assessing the readiness of practice management and electronic health records vendors and targeting outreach to them, and

*Continuing to expand provider education efforts, particularly to smaller and vulnerable organizations.

More survey results are available here.

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