Industry Lags on ICD-10 Implementation

A recent survey of AHIMA members shows that just over half of organizations have started their transition to ICD-10-CM/PCS. Fifty-three percent of 645 respondents reported that they or their facilities had begun at least the initial planning steps.

The snapshot, taken in August, reflects a slight improvement from an April 2010 AHIMA survey in which 48 percent of respondents reported that planning had begun.

Among the respondents whose facilities had not begun work in August, implementation will not begin in the immediate future. Thirty percent said ICD-10 planning would begin in one to six months. Another 19 percent said it is more than six months away, and 46 percent did not know when efforts would begin. These numbers are similar to responses logged in the April 2010 survey.

A majority of the April and August surveys were answered by HIM directors and managers (87 percent in August), a group typically responsible for either jump-starting or participating directly in ICD-10 implementations.

Coding experts have said facilities should now be well into their ICD-10 implementation plans, and that delaying will make it extremely difficult to meet the compliance deadline of October 1, 2013.

Hospitals Ahead

Inpatient hospitals were ahead of the overall survey average, however, with 62 percent of respondents saying their hospitals have started ICD-10 efforts. In the April survey, 56 percent of reported the same.

Of the 38 percent of hospital-based respondents that have not started, 18 percent were more than six months away from beginning, and 41 percent said they did not know when ICD-10 implementation would start.

Moving through the Stages

Of those who have started ICD-10 planning, August respondents reported further progress on major milestones than did respondents in April.

A first milestone in the transition involves determining organizational structure and responsibilities for the ICD-10 transition and the related upgrade to the HIPAA 5010 transaction standards. This includes developing an interdisciplinary steering committee to develop ICD-10 implementation strategies.

In August, 22 percent of respondents in total said their organizations were from “more than half” to “finished.” Only 14 percent of respondents in April had reported the same progress.

However, AHIMA recommends that all facilities should have completed this step a year ago.

An organization’s individual timeline will vary based on its size, type, and structure, but AHIMA recommends that all organizations should have by this time at least established an interdisciplinary steering committee to oversee implementation, raised awareness with key stakeholders, and begun an impact assessment. The August survey shows a wide majority of respondents are behind in these tasks.

The consequences of running late on the implementation can be significant.

Claims for services provided on or after October 1, 2013, must use ICD-10-CM or ICD-10-PCS or face denials, CMS has written on its Web site. There will be no extension or grace period, CMS warns, and noncompliant claims will have to be resubmitted with ICD-10 codes.

AHIMA’s complete ICD-10-CM/PCS preparation checklist may be found on the association’s ICD-10 resources page. Also available is a readiness assessment and prioritization tool and a role-based training model.

5010 Efforts Also Trailing

AHIMA’s survey also captured slow progress on the transition to the 5010 transaction standards. The upgrade is necessary to support ICD-10-CM/PCS, and the Centers for Medicare and Medicaid Services has set a deadline of January 1, 2012, for the switch.

By December 31, 2010, CMS recommends that organizations have completed internal testing of the new standards. In 2011, they should perform end-to-end testing with all of their external partners.

Just 16 percent of respondents in AHIMA’s August survey reported that their facilities were at least half done with systems testing. The number is low, but it does reflect an increase over the April survey, when 10 percent of respondents reported the same.

Many facilities appear to lack even a plan. Among the August respondents, 28 percent said their facilities had not determined their 5010 implementation strategy (either internally or with their vendors). An additional 39 percent had “just started” on their strategies.

It is possible 5010 progress could be underreported in the survey. HIM professionals may be less familiar with their facilities’ 5010 efforts, because they typically do not play as direct a role in the 5010 upgrade as they do in the ICD-10 transition.

For more on the 5010 upgrade, read “Preparing for the 5010” in the January 2010 issue.

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