Only 10 percent of physicians in the Lone Star state are “very confident” their practice is prepared to meet the ICD-10 deadline on October 1, according to a new survey by the Texas Medical Association.

Doctors employed in hospitals are least likely to be very confident their practice is prepared to transition to ICD-10 (5 percent), finds the survey. Overall, few physicians have begun transitioning to ICD-10 extensively (7 percent), while those employed in hospitals are least likely to feel their practice has begun to transition to ICD- 10 extensively (3 percent).

Last month, the Texas Medical Association—the largest state medical society in the nation—emailed a link to the online survey to 36,786 members and non-members. The survey is based on 936 responses received by the association. Almost half of the physicians surveyed (42 percent) were solo practitioners.

About three-quarters (74 percent) of doctors in the survey said they either have not started or have only made some progress in the code switchover, while a staggering 82 percent of solo practitioners indicated they have made little or no progress. Even among physicians who feel very confident their practice is ready for ICD-10, only 42 percent report their practice has begun transitioning extensively.

The disturbing results paint a picture of a lack of ICD-10 readiness among Texas doctors—much higher than a recent survey by the California Medical Association which found that more than half of physician practices in the state were only minimally prepared for the code switchover, while more than a fifth indicated they were not at all prepared.

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

As a result of the ICD-10 transition, 83 percent of Texas doctors responding to the survey anticipate delayed or denied claims and more than a third (36 percent) of the physicians expect disruptions requiring them to draw from personal funds to keep their practice open and nearly a third (30 percent) indicated they might retire early over anticipated cash-flow problems. In addition, nearly a third (32 percent) might cut employees or reduce employee work hours or benefits.

“It’s horrible,” said Tom Garcia, M.D., president of the Texas Medical Association, in a written statement. “The United States is the only country that couples the ICD coding with payment. The implications are that the doctor/patient relationship is going to be stressed.”

The silver lining for doctors, according to Garcia, is that the Centers for Medicare and Medicaid Services and the American Medical Association have announced a “grace period” for physicians transitioning to ICD-10. Under the agreement, Medicare will not deny doctors’ claims for one year whose ICD-10 codes are not specific enough, provided they submit a code from the correct family of codes.

“I asked for two years’ grace period but they only gave us a one year grace. I think it is going to take at least three years before this thing is finally settled down,” Garcia added.

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