In the run-up to the October 1 ICD-10 deadline, many providers have completed key steps in the implementation process but still lag behind when it comes to testing, and most expect to continue managing the switchover after the deadline.

Those are among the findings of a new eHealth Initiative survey in conjunction with the American Health Information Management Association. The third annual survey of 271 providers, conducted May-June 2015, measured preparedness for ICD-10 implementation/testing as well as perceptions of the financial, operational, and clinical impact of transitioning to the new code set.

Perhaps most concerning is that testing isn’t something that most providers have completed at this point. In fact, only half of respondents have conducted test transactions using ICD-10 codes with payers and clearinghouses. And, even fewer providers indicated that they have completed all internal testing (34 percent) and external testing (17 percent). 

Also See: 21% of California Physician Practices Not Ready for ICD-10

According to the survey results, the top five ways that providers are preparing for the ICD-10 transition are: providing ICD-10 awareness and educational materials to staff (78 percent); forming a team to assess readiness and prepare for implementation (73 percent); training staff on using ICD-10 (72 percent); performing technical system upgrades/updates to support ICD-10 (66 percent); and evaluating internal organizational processes, workflow, and resources (64 percent). However, the survey also reveals a preparedness gap between larger and smaller provider organizations, with the former reporting more progress in preparing for the ICD-10 transition.

“It’s very concerning that about 14 percent of physician practices and almost 12 percent of the small organization category have not completed any of the steps to prepare for ICD-10,” said Sue Bowman, AHIMA’s senior director of coding policy and compliance. “That is extremely concerning since it is now mid-June and the October 1 compliance date is fast approaching.”

Not surprisingly, most provider organizations surveyed believe the ICD-10 transition will reduce their revenues due to decreases in staff productivity or accuracy resulting in claims denials and rejections. To mitigate productivity losses, organizations plan to: offer additional trainings and practices (53 percent); contract with outsourced coding companies (51 percent); hire additional coders (41 percent); purchase computer assisted coding technology or tools (35 percent); and autocode from electronic health record templates (12 percent).

Still, Bowman noted that “quite a few healthcare organizations still have not conducted a revenue impact assessment,” which she said is a “key step to understanding exactly how your organization’s revenue is going to be impacted on October 1.”

In terms of post implementation activities, a majority of respondents plan to continue evaluating and managing the impact of ICD-10 post-compliance by: tracking claims denials and rejections (83 percent); evaluating coding productivity and accuracy (81 percent); tracking reimbursement levels (72 percent); providing additional ongoing training for staff (72 percent); and monitoring system functionality (64 percent). Only 3 percent of providers are not planning to assess the impact of ICD-10 following the October 1 deadline.

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