It's time to get ready for ICD-10 – TechAdvisory.org

HealthcareIT_July03_AThe compliance date for ICD-10 is farther away than it once was, but it’s still coming — and health-care practitioners should be moving forward with preparedness plans, if the results of a recent survey are any indication.

The survey — which questioned physician practices, hospitals, payers, vendors, and others — was conducted by eHealth Initiative and the American Health Information Management Association (AHIMA).

It found that most health-care organizations are using the extra time afforded by the delay of ICD-10 compliance to October 15 to invest, train, and test. Most organizations said they’re ready for testing, but some are more prepared than others. Around 40 percent of respondents said they’d start end-to-
end testing by the end of 2014, and 25 percent reported that they’d begin by the end of 2015. And, to minimize productivity loss, 68 percent of respondents said they will conduct additional training, with 31 percent hiring more coders to help with the transition.

Concerns about ICD-10 remain, however. One pertains to preparedness, with 45 percent of respondents reporting that they don’t have a good sense of their partners’ readiness. Another pertains to financial impact, with 38 percent of respondents saying they thought their revenue will decrease, and 14 percent saying they think it will stay the same. Only 6 percent think it will increase.

Clearly, while the ICD-10 transition seeks to improve accuracy of claims and quality of care, not everyone has a clear plan to derive value from it. But now, it seems, is the best time to prepare. We recommend that you contact us today to learn more about how we can help ensure that you are ready for ICD-10.

KLAS: Providers' Third-Party Needs Shift in Wake of ICD-10 Delay

A one-year delay of the ICD-10 deadline may lead some healthcare providers to postpone training and testing of related projects, according to a new report from the Orem, Utah-based KLAS research.  

For others, the focus will remain on identifying which third-party vendors can best help them prepare for their eventual adoption of the new coding guidelines.

The report states that 54 percent of interviewed providers named training and education as the most important areas in which outside help is needed. Many providers are using or planning to use a combination of eLearning tools and on-site training to help their staff prepare for the switchover. Precyse is the firm most frequently used for eLearning, and 3M and Precyse have the most providers using them for on-site physician training. Optum and 3M scored the highest marks for on-site training, while 3M and Precyse have the most providers utilizing them for help for on-site physician training. The Advisory Board received the highest overall ICD-10 consulting performance score.

However, training and education timelines will likely change to reflect the new deadline.  System and end-to-end testing are other areas in which providers are looking for outside assistance, yet the field of firms who provide this help is narrow, and no firms appear to have deep experience in this area, according to the report.

“While demand was high for ICD-10 training and system and end-to-end testing, not many providers that we spoke with were utilizing their firms in these areas,” Mike Smith, report author, said in a statement. “Part of this may be due to timing. Prior to the ICD-10 delay, I anticipated that we would see many more of these types of engagements in the coming months. However, many of these projects will now be pushed to 2015.”

Focus on Healthcare: 3 Physician Misconceptions about ICD-10

Question: What happens when you ask 2 physicians about how ICD-10 will impact them?


Answer: You get 3 different perceptions


This is a twist on an old joke but understanding what the typical physician knows about ICD-10 and what they misunderstand about ICD-10 is key to identifying your practice’s education needs, including who needs training, what type (and level) of training is required, and how each person should be trained.


Since physicians are responsible for the final diagnosis and are responsible for documentation, let’s look at the top 3 misconceptions (and share what you are hearing in the comments below):


Misconception #1: The only staff members affected will be coders and billers


True, physicians are not expected to learn to code. However, ICD-10 will require physicians to document at a level of specificity not previously required in ICD-9, for example including laterality, episodes of care, stages of healing, weeks in pregnancy, etc.   Keep in mind, the best trained coders can only code based on the documentation available to them so if documentation is missing, coders are required to return records to the physician for clarification and addendums.  And you know how a physician will respond if they receive a lot of queries, so let’s prevent this from happening.


Misconception #2: My EMR/PM vendor will automatically be compliant so I do not have to be involved


Yes, most major EMR’s and Practice Management systems are introducing ICD-10 compliant systems but physicians need to begin working now to assess where they use diagnosis codes, how they use them, and who uses them so they are prepared to make necessary process and system changes and provide training to those who will need it. For example, ancillary order forms on October 1, 2014 must include the correct ICD-10 diagnosis code or a patient will not be able to have diagnostic studies done at hospitals and clinics.


Misconception #3: Physician education can wait until summer 2014


No.  The Medical Group Management Association (MGMA) recommends physicians start training about 3-6 months ahead of the October 1st deadline.  By starting early, there will be time to start identifying areas that need focus and prevent unnecessary surprises.


 


Let me know what you think in the comments below.


Ready to hear how to make physician education engaging and relevant?  Join me at the upcoming webinar on February 13th, click here to register.

Even the NYTimes is writing about the upcoming ICD 10- Here …

Next fall, a transformation is coming to the arcane world of medical billing. Overnight, virtually the entire health care system — Medicare, Medicaid, private insurers, hospitals, doctors and various middlemen — will switch to a new set of computerized codes used for determining what ailments patients have and how much they and their insurers should pay for a specific treatment.

The changes are unrelated to the Obama administration’s new health care law. But given the lurching start of the federal health insurance website, HealthCare.gov, some doctors and health care information technology specialists fear major disruptions to health care delivery if the new coding system — also heavily computer-reliant — isn’t put in place properly.

They are pushing for a delay of the scheduled start date of Oct. 1 — or at least more testing beforehand. “If you don’t code properly, you don’t get paid,” said Dr. W. Jeff Terry, a urologist in Mobile, Ala., who is one of those who thinks staffs and computer systems, particularly in small medical practices, will not be ready in time. “It’s going to put a lot of doctors out of business.”

The new set of codes, known as I.C.D.-10, allows for much greater detail than the existing code, I.C.D.-9, in describing illnesses, injuries and treatment procedures. That could allow for improved tracking of public health threats and trends, and better analysis of the effectiveness of various treatments.

Officials at the Centers for Medicare and Medicaid Services declined to be interviewed about the new codes. But a spokeswoman said that the agency was “committed to implementing I.C.D.-10 on Oct. 1, 2014, and that will not change.”

In a letter in November, Kathleen Sebelius, the secretary of health and human services, told Senator Jeff Sessions, Republican of Alabama, that the Medicare and Medicaid officials were working diligently to help doctors get ready. “I.C.D.-10 is foundational for building a modernized health care system that will facilitate broader access to high quality care,” she wrote.

Still, the troubles with HealthCare.gov have given new ammunition to those urging a go-slow approach on I.C.D.-10 and have made it harder for the government to stand behind assurances that the transition will go smoothly.

“Failure to appropriately test I.C.D.-10 could result in operational problems similar to what the Department experienced with the rollout of HealthCare.gov,” the Medical Group Management Association, which represents the business managers of medical practices, said in a letter this month to Ms. Sebelius.

The Medicare and Medicaid office now appears to be open to greater testing of the system. Also this month, the Obama administration relaxed some deadlines for parts of the health care law, and some deadlines under a separate law for enacting electronic medical records.

“I think that people at C.M.S. understand the stakes with respect to I.C.D.-10 in a heightened way as a result of HealthCare.gov,” said Linda E. Fishman, senior vice president for policy at the American Hospital Association.

Dr. John D. Halamka, chief information officer at Beth Israel Deaconess Medical Center in Boston, said the need to prepare for I.C.D.-10 and the Affordable Care Act and to achieve so-called meaningful use of electronic health records all at once could overwhelm computer staffs throughout the health care industry.

“It’s just this collective sum of activities that exceeds the capacity of the system to absorb it simultaneously,” he said. He said his hospital was spending $5 million this year on I.C.D.-10, $7 million for the Affordable Care Act, $2 million on meaningful use, and $3 million to comply with a federal health care privacy law. “Basically, I’m not doing anything but federal regulatory mandates,” he said.

I.C.D.-10 has already been postponed by a year. It was originally scheduled to go into effect this past Oct. 1, which would have coincided with the rollout of the ACA. Some health care executives say predictions of a fiasco next Oct. 1 will prove as erroneous as those that said civilization would collapse on Jan. 1, 2000, because computers could not handle years beginning with a 2 instead of a 1 — the so-called Y2K issue.

 “It’s not going to be a shock to the industry to confront this,” said Christopher G. Chute, professor of biomedical informatics at the Mayo Clinic. “We’ve literally had seven or eight years to anticipate it.”

A survey by the American Hospital Association this year found that about 94 percent of hospitals were moderately to very confident about being ready on time. Both the hospital association and America’s Health Insurance Plans, which represents insurers, said that their members had spent a lot of time and money getting ready for I.C.D.-10 and that the changeover should not be postponed again.

I.C.D.-10 is the 10th revision of the International Classification of Diseases, which is issued by the World Health Organization, though countries can modify it. Having a common global code allows for easier collection, comparison and analysis of the causes of death and illness. Most other countries have already adopted I.C.D.-10, at least for record-keeping and in some cases for reimbursement.

The classification was first issued in the 1800s. An early one listed “visitation of God” as one cause of death.

But as medical knowledge and technology have improved, more codes are needed. I.C.D.-9, which allows codes of up to five characters, has about 14,000 codes to specify diagnoses and 3,000 to specify inpatient procedures. The code, which has been used in the United States for medical statistics since 1979 and for billing since 2002, has run out of room to incorporate new knowledge and technology.I.C.D.-10, with codes containing up to seven digits or letters, will have about 68,000 for diagnoses and 87,000 for procedures.

While I.C.D.-9 had a single code for certain repairs to blood vessels in the head and neck, I.C.D.-10 allows specification of the particular vein or artery and the particular procedure used. Extra codes allow recording of whether a patient was visiting the doctor for the first time or a subsequent time for a particular problem, and whether broken arms and some other injuries occur on the left or right side of the body.

There are dozens of codes dealing just with the big toe — contusion of the right great toe, contusion of the left great toe, with damage to the nail or without, initial encounter or subsequent encounter, blisters, abrasions, venomous insect bites, nonvenomous insect bites, lacerations, fractures, dislocations, sprains and amputation, not to mention the vague “acquired absence of unspecified great toe.”

I.C.D.-10 has been the subject of jokes, however, for its catalog of possible injury causes, like those burning water skis. There are codes for injuries incurred in opera houses and while knitting, and one for sibling rivalry.

When it first proposed moving to I.C.D.-10, the Medicare and Medicaid Services office estimated it would cost the government and industry $1.64 billion over 15 years on training, software changes and lost productivity. But it also said the system would bring $4 billion in benefits over that time, from more accurate claims and improved health care.

Lee Browder, national director of the Professional Association of Healthcare Coding Specialists, said the transition should not be too hard for coders. He compared it to the introduction of the extra four digits on ZIP codes — there were many more codes, but the concept was the same as before.

The transition could be tougher for doctors, because they will have to be more specific in describing a patient’s condition. The government has said Medicare contractors will have a week of testing in early March during which doctors and hospitals can practice submitting claims. But the Medical Group Management Association and the American Hospital Association, among others, are pushing for more testing.

Rhonda Buckholtz, vice president for I.C.D.-10 education and training at the American Academy of Professional Coders, said postponing the deadline would just push the problem down the road.

“It doesn’t matter what deadline we get,” she said. “We’ll find a way to not meet it.”

Providers, Payers and CMS Gear Up for ICD-10 Implementation, but …






Pathologists and medical laboratory managers have only nine months to prepare their labs for ICD-10 implementation

Most clinical laboratory managers and pathologists know that October 1, 2014, is the date for implementation of ICD-10. After that date, each Medicare claim submitted by a medical laboratory must include the ICD-10 code provided by the referring physician.

This is a unique reason why clinical laboratories and pathology groups have keen interest in a smooth transition from ICD-9 to ICD-10. Medicare will reject clinical laboratory test claims that either don’t have an ICD-10 code or have an incorrect ICD-10 code. Thus, labs hope that their client physicians make a smooth transition from ICD-9 to ICD-10.

Nine Months Remain before Launch of ICD-10 in the United States

With just nine months remaining before the October 1, 2014, the date of implementation, many providers have not yet begun the rigorous training needed to prepare physicians, clinical staff, and medical coders to use ICD-10. That is equally true for information technology departments (IT). With less than a year left before implementation, provider IT departments are working furiously to prepare for the launch, noted a report published by Modern Healthcare.

Implementation of ICD-10 poses gargantuan challenges for providers. That’s because ICD-10CM (clinical modification) has 68,000 codes, which is five times as many codes as ICD-9CM. ICD-10PCS (procedural coding system) is even more complex, with 87,000 new codes, 29 times more ICD procedural codes currently used by hospitals.

Hospitals Need to Train Physicians and Staff

Consequently, hospital IT departments must train physicians—most of whom are independent, community-based practitioners—to capture what hospitals and physicians do and translate that information into discrete diagnoses, procedures and billable events pointed out Charlene Webber-Schuss, CIO at Community Hospital of the Monterey Peninsula in Salinas, California, who was quoted in the Modern Healthcare report. “We are concerned about a lot of the community practices,” she said. “If the doctors do not provide adequate documentation, both doctors and hospital will suffer lost revenue,” she explained. Webber-Schuss’ department has already spent eight months and $900,000 in IT resources to prepare for ICD-10 rollout.

Charlene Webber-Schuss

Charlene Webber-Schuss (pictured), CIO at Community Hospital of the Monterey Peninsula, is currently engaged in preparing physicians for the ICD-10 transition. She noted that if physicians are not trained to accurately code documentation, both physicians and hospitals will lose revenue. (Photo by CHOMP.org.)

The extent of code changes will vary by physician specialty. Gail Eminhizer, Practice Administrator for Digestive Health Associates in Traverse City, Michigan, noted that her six-physician gastroenterology practice only has 30 new codes to deal with. But other specialties, such as family practitioners, rheumatologist and orthopedic surgeons, will see daunting expansion in the number of codes.

Proponents of ICD-10 contend that it will allow providers to better track patient care and aggregate data to perform quality-improvement analysis. The newer ICD version also provides hospital administrators and physicians with improved tools to analyze the impact of new procedures and manage population health.

But the high cost of converting to ICD-10 has been a difficult pill to swallow for most hospitals and physicians. This is particularly because their IT departments are under pressure to improve performance on many fronts, noted the Modern Healthcare article. At the same time, IT departments are tasked with meeting meaningful use standards of operability for electronic health records (EHRs) and generating numerous reports that help quality and safety officials improve performance and avoid government penalties.

What Will the ICD-10 Transition Cost? Who Will Pay?

Additionally, upon implementation, the more complex ICD-10 coding system may also trigger financial consequences. These can range from lost revenue due to delays in imputing data to rejected claims from improper coding or malfunctioning IT systems.

Hospital financial officers are concerned about the impact the new coding system will have on reimbursement, even though most ICD experts contend its impact will be revenue neutral. ICD-10 is supposed to make payment more precise—that is if hospitals and physicians fully and accurately document services.

The federal Centers for Medicare & Medicaid Services (CMS) estimated that the transition will cost $1.64 billion over 15 years, with IT costs accounting for 43% of that amount. IT costs will be spread across multiple participants, including the federal government ($315 million), payers ($164 million), providers ($137 million) and software developers ($96 million). Providers will be the hardest hit, however, with the remaining 57% of the $1.54 billion going for training ($356 million) and anticipated loss in productivity ($571 million).

As much as $4 billion in benefits is predicted by the government. The benefits include more accurate payments for new procedures, fewer rejected claims, and improved disease management, along with a better understanding of health conditions and outcomes, reported Modern Healthcare.

The Argument for Delaying Rollout of ICD-10

Christopher G. Chute, M.D., Dr. P.H., is a veteran physician informatics specialist and professor at Mayo Clinic. He was among the medical IT heavyweights who last year authored an article in the journal Health Affairs that called for a one-year delay in ICD-10 implementation. The authors argued that the conversion will be “expensive, arduous, disruptive, and of limited direct clinical benefit.”

Christopher Chute, M.D

Christopher Chute, M.D., (pictured above) is a specialist in physician informatics and professor at Mayo Clinic. He joined with other biomedical Informatics heavyweights to publish an article in the journal Health Affairs, calling for a one-year delay in implementing ICD-10. (Photo copyright Christopher Chute, M.D.)

A survey by the American Medical Association, which supports delaying ICD-10 rollout, found that 94% of 785 hospitals who participated are moderately or very confident they will be ready for the launch next October. However, about 75% of surveyed hospitals are concerned that Medicare won’t be ready to test its ICD-10 submissions. (See Dark Daily, “HHS Proposes One-Year Delay for ICD-10 Implementation: Is This Good News for Clinical Pathology Laboratories?”)

Who Will Test ICD-10 IT Systems?

To avoid problems, National Government Services, a CMS Medicare Administrative Contractors (MACs), recommended that CMS perform external, “end-to-end” ICD-10 testing of all participants in the healthcare claim stream, including providers, claims clearinghouses and payers, noted the Modern Healthcare report.

But Cathy Carter, Director of the CMS Information Office, Business Applications Management Group, said MACs will perform rigorous in-house testing of the system before the October 1, 2014 deadline. At the same time, she also admitted “There is no money or process or time” for Medicare contractors to do external end-to-end testing.

ACLA Recommendations to Medical Laboratories to Prepare for ICD-10

Since clinical laboratories are indirect providers, they will need to rely on physician clients to provide accurate ICD-10 codes on requisitions for medical laboratory tests. Therefore, the importance of ICD-10 coding education and training for ordering clinicians and their office cannot be overstated, noted an article published on the American Clinical Laboratory Association (ACLA) Website.

ACLA also recommended forward mapping from ICD-9CM to ICD-10CM for claim submission purposes. This would be done in those instances where an ICD-9CM code is received from an ordering provider, but an ICD-10CM code is required for payment by the Medicare program.

Of course, there will be a cost to medical laboratories to help in this training of physicians. One nationwide clinical laboratory has estimated that the transition will cost it $40 million. (See Dark Daily, “Labs Likely to Face Expensive Conversion Costs for ICD-10” Laboratories and Physicians expect higher costs for ICD-10.)

—By Patricia Kirk

Related Information:

Expensive. Confusing. Time consuming: Looming shift to more complex ICD-10 coding system has hospitals and physicians scrambling

ICD-10

HHS Proposes One-Year Delay for ICD-10 Implementation: Is This Good News for Clinical Pathology Laboratories?

Anticipating the Disruption from HIPAA 5010 Forms and ICD-10: Essential Action Steps to Maintain Your Lab’s Cash Flow

HHS Delays Implementation Deadline

Labs Likely to Face Expensive Conversion Costs for ICD-1

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Career Step Physician Advisor Speaks on Need fo ICD-10 … – PRLog

PRLog (Press Release)Nov. 15, 2013In a recent Talk Ten Tuesdays broadcast, Career Step physician advisor Dr. Stephen Spain, MD, CPC, addressed the need to educate physicians on the impact the ICD-10 transition will have on their documentation. Dr. Spain was featured in the ICD-10: The Perfect Storm episode of Talk Ten Tuesdays, a popular podcast series produced by ICD10monitor.

“My biggest concern is that so many physicians believe the transition to ICD-10 is not going to happen—that somehow it will be canceled or postponed one more time,” said Dr. Spain. “Our job is to get physicians to develop a vested interest in preparing for this conversion. I am concerned that many physicians think this is a billing or coding issue that will not impact them very much. This could not be farther from the truth.”

A recent Modern Healthcare article (http://www.modernhealthcare.com/article/20131023/NEWS/310…) on an ICD-10 pilot program conducted by the Healthcare Information and Management Systems Society and the Workgroup for Electronic Data Interchange touched on the importance of physician training. The article noted that negative results may have been due to imprecise medical documentation not adequate for the new ICD-10 codes, pointing to the need for physicians to hone documentation skills in preparation for changes ICD-10 will require.

“If physicians have an uncommitted attitude toward this transition, it could portend disaster,” continued Dr. Spain. “Career Step’s program plan is to begin physician education with general concepts regarding the reasons behind the transition and the structure of ICD-10, without making them coders. The next step is to explain how this transition is going to affect their specific workflow and documentation requirements. I think once physicians have an understanding of that, they’re going to be very interested in the transition because it’s going to have a tremendous impact on their practice workflow.”

As Career Step’s physician advisor, Dr. Spain provided guidance on the content and approach of Career Step’s new ICD-10 Physician Education and Training and introduces the program’s ICD-10: Understanding its Purpose and Value module. Career Step training encourages physician interest in ICD-10 by providing education that can be tailored to their specific needs. The ICD-10: Understanding its Purpose and Value module is designed for all physicians, and the curricula also includes 24 specialty training programs to make the best use of providers’ time and optimize knowledge retention in preparation for the transition. All of the Career Step training modules are approximately 15 minutes in length and are delivered online, making the training available anytime, anywhere on a variety of technology platforms.

Dr. Spain is a family physician with over 30 years of practice experience. He earned his Certified Professional Coder (CPC) credential in 2007, is the immediate past president of the Tyler Chapter of the American Academy of Professional Coders (AAPC), and recently served as a member of the National Advisory Board of the AAPC.

To listen to the archived podcast, visit http://icd10monitor.com/index.php?option=com_content&…. For more information on Career Step’s ICD-10 Physician Education and Training, visit http://corporatetraining.careerstep.com/physician-educati… or call 1-888-989-7512.

About Career Step

Career Step, an online provider of career-focused education and corporate training, has trained over 85,000 students, has more than 150 partnerships with colleges and universities nationwide, and provides training for some of the most respected healthcare employers in the nation. Career Step is committed to helping students and corporate employees alike gain the skills they need to be successful in the workplace, improving lives and business results through education. The institution’s training programs are currently focused in healthcare, technology and administration, and more information can be found at www.careerstep.com (http://www.careerstep.com/?uid=pub131115) or 1-800-246-7836.

“power up” for ICD-10! – Sentara Today Blog for Sentara Healthcare …

power-of-10Just as the children are going back to school during the fall, many Sentara employees are also preparing for their own training and education to learn the new diagnostic coding system that all healthcare providers in the U.S. must adopt next year.

Currently every U.S. healthcare provider and insurer use the ICD-9 system, a healthcare documentation and coding system used for documenting diagnoses and procedures in healthcare. This coding system is used for classifying diseases, symptoms, complaints, circumstances and causes of injury or disease.

While most of the world adopted the new coding system in the ‘90s, the United States waited. Now, we must catch up with the rest of the world. The U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid made the decision for the U.S. to move forward with the adoption. On Oct. 1, 2014, all healthcare providers and insurers must adopt ICD-10.

Sentara has been preparing for this conversion for years. This summer the health system’s “Power of Ten” Committee – the interdisciplinary group charged with managing the transition – selected two vendors for computer-based training, Precyse and 3M. The committee also has identified employees throughout the Sentara Healthcare system that will require training at various levels to meet the demands of their jobs.

Four levels of training have been identified and defined. Level 1, “general awareness,” is for every employee. All Sentara employees and physicians have a need to know that this conversion is taking place. Level 2, “knowledge,” is for individuals who may not document or code, but need to know ICD-10 to do their jobs better. Approximately 2,500 employees will receive this level of training, ranging from two to four hours.

Level 3 training, “provider,” is for clinical employees who document patient diagnoses, procedures, and care in the medical record. For example, physicians, physician’s assistants and nurse practitioners, who care for patients in a hospital setting, will receive this level of training. These folks will undergo a blended training approach with the use of computer-based training, in-person instruction, and various other tools. Those receiving this training are approximately 3,200 individuals. Finally, Level 4 training, “expertise,” is for those needing complete and full knowledge – coders, auditors and clinical documentation specialists. Five hundred individuals will receive this training.

Training for coders has already begun, and training for others will begin in the coming weeks to months. The Power of Ten Committee is in the midst of developing the schedules based on when ICD-10 will impact job responsibilities.

Stay tuned for more updates on Sentara’s journey as we “power up” from ICD-9 to ICD-10!

Small hospitals playing ICD-10-guessing game with payers …

With only a year until the ICD-10 transition, smaller hospitals have jumpstarted their staff training but still lack preparations to work with payers, according to a new survey from Health Revenue Assurance Holdings (HRAA).

The survey involved 200 hospital administrators, hospital health information professionals and compliance employees and found 78 percent have started ICD-10-CM training for coding staff, up from 60 percent last quarter. And 64 percent of hospitals have begun training coding staff on ICD-10-PCS, up from last quarter’s 45 percent.

While providers should plan for 16 to 24 hours of training for clinical staff and 40 to 60 hours for coding staff, everyone from the appointment scheduler to midlevel providers to physicians must understand specific documentation, medical necessity and third-party payer guidelines under the new code set, FiercePracticeManagement previously reported.

In addition to increased training efforts, the HRAA survey found small- and mid-sized hospitals also are focusing on improving clinical documentation, with 68 percent providing medical staff with document improvement education, compared to 53 percent last quarter.

“The not-so-good news is that they are not putting enough resources against understanding how their payers will operate once the ICD-10 transition takes place,” HRAA Chairman and CEO Andrea Clark said in the survey announcement.

For instance, 72 percent of hospitals don’t know if their payers intend to use the Centers for Medicare & Medicaid Services reimbursement maps to group the claims to DRGs while 85 percent still haven’t found out how their payers are mapping claims, according to a related infographic.

The survey findings suggest hospitals are opening up their organizations to substantial claims denials and delayed payments when the transition kicks in next October. So hospitals need to implement financial modeling and denial strategies now to avoid playing a guessing game with payers.

Provider-payer coordination is key to ensure a smooth transition to the new code set. With that in mind, Independence Blue Cross, which expects to be ready for ICD-10 implementation, has launched an outreach program and testing program to boost the provider community’s ICD-10 readiness, FierceHealthPayer previously reported.

For more
- here’s the survey announcement
- check out the related infographic (.pdf)

Related Articles:
Partner with providers to ensure ICD-10 readiness
The financial impact of ICD-10: How do you prepare for the unknown?
3 recommendations for smoothing ICD-10 transition wrinkles
ICD-10 training: Who needs it, how long it will take and what it will cost