HIT Think

ICD-10 Deadline: Ready or Not, Here It Comes

Today is St. Patrick's Day, a sobering reminder that there are less than 200 days left until the October 1 ICD-10 implementation deadline. Either way, if you are a provider that is concerned about being prepared to make the code switchover, no one could blame you for having a good, strong drink (or two).

With only the spring and summer months separating providers from the ICD-10 go-live date, many are asking themselves how far along they should be at this point in implementation activities. Well, the truth is that significant numbers of providers have not even begun to prepare for ICD-10, as terrifying and as stressful as that may sound. A recent poll of 1,200 practices with more than 55,000 physicians found that less than 10 percent reported significant progress in overall ICD-10 readiness.

The migration from ICD-9 to ICD-10 codes is a daunting, large scale implementation that impacts every aspect of healthcare operations. On that Wednesday in October, if providers are not able to code in ICD-10 to bill for services and procedures, their claims will not be processed and they will suffer cash flow interruptions, additional costs and delayed claims payments, not to mention audits. In an article in this month's issue of the Journal of Oncology Practice, researchers at the University of Illinois at Chicago found that the transition to ICD-10 may cause information and financial losses for providers.

"These issues could extend beyond practices to healthcare organizations such as imaging centers and laboratories that might not be able to fully accept ICD-10, forcing providers to submit ICD-9s and ICD-10s at the same time," wrote Brian Anderson, a family physician and senior manager of clinical content for athenahealth, in a recent blog. "If a provider practice hasn’t completed its testing, staff training and development of new documentation workflows by the October deadline, then they’re going to experience greatly impaired efficiency for a long time afterward."

It's the reason the American Medical Association last month sent a letter to Health and Human Services Secretary Kathleen Sebelius calling for a delay in the October 1 deadline to give practices more time to prepare for the financial and administrative requirements. In the letter, AMA argued that the vendor community isn’t ready to support physician migration to ICD-10, with less than half of physicians expecting that their practice management vendor will be able to deliver an ICD-10 compliant upgrade.

Those of you who were looking for an extension of the October 1 deadline were no doubt sadly disappointed when the Centers for Medicare and Medicaid Services stuck to its guns at HIMSS14, announcing that the date is not flexible and neither is the agency. "We've delayed this several times and it's time to move on,” declared Administrator Marilynn Tavenner at last month's conference. At least in the case of Stage 2 EHR meaningful use requirements, CMS is willing to consider granting hardship exemptions to providers struggling with vendor issues, however, when it comes to ICD-10, no such luck.

The message from CMS couldn't be clearer: ready or not, here comes the ICD-10 deadline. And, so, I propose a toast on this St. Pat's Day taken from the lyrics of Peter Gabriel's apocalyptic song "Here Comes the Flood": Drink up, dreamers, you're running dry.

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