Survey: Provider ICD-10 Testing with Payers Lags in Final Months

Healthcare providers are struggling to complete adequate testing for ICD-10, and smaller providers still face a readiness gap. However, providers are feeling more optimistic about the upcoming transition in October and are starting to see the benefits of the new code set, according to the results of a new provider survey.

The survey, which was conducted by AHIMA and the eHealth Initiative, is the third annual such survey on provider readiness, with previous iterations published in 2013 and 2014. It included responses from 271 participants and focused on readiness for testing and implementation, anticipated financial, clinical, and operational impacts of the transition, and post-implementation strategies for maintaining productivity.

Cause for Concern

The survey found that providers have made significant strides in providing education and awareness training for staff. For example, 73 percent of respondents formed a team to lead efforts to prepare for implementation, and nearly the same amount trained staff on new codes.

But when it comes to more comprehensive planning tasks such as sending test claims to payers and clearinghouses, the rates were more dismal. Fifty percent of respondents had conducted test transactions with payers or claims clearinghouses, while only 17 percent believed they had completed all external testing.

For smaller providers, “low testing rates may be indicative of a general lack of preparedness among smaller organizations. If an organization has not completed many of the steps leading up to implementation, they likely aren’t prepared to test ICD-10 transactions,” the report authors wrote.

The report found that in general, small providers were less likely to have completed most types of preparedness activities.

A Bright Side

While concerns about workflow and revenue persist in the 2015 survey, providers have a rosier view of the ways in which ICD-10 can making certain activities easier than they did in previous years’ surveys. According to the survey, slightly more respondents actually thought ICD-10 would improve the accuracy of claims (35 percent) rather than worsen them (31 percent).

“Even in categories that are widely regarded to be more difficult with ICD-10, such as coding and documenting patient encounters, a higher percentage of respondents in 2015 thought these activities would be easier than in 2014,” the authors wrote.

The report offered the following recommendations for providers to focus on between now and the ICD-10 go-live date on October 1:

  • Engage in external testing
  • Collaborate with stakeholders
  • Utilize existing resources
  • Conduct a revenue impact assessment
  • Develop a contingency plan

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