ICD-10 transition is 'one of the most complex and expensive changes our healthcare system has faced in decades'

July 10, 2013

The ICD-10 transition is a costly one for physicians, who must often purchase new information technology systems and train staff on the new coding system.

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It’s been several years since the federal government announced that healthcare providers would have to transition from the International Classification of Diseases, 9th revision (ICD-9) code sets to ICD-10-which contains roughly five times the number of codes as its predecessor. The transition is a costly one for physicians, who must often purchase new information technology systems and train staff on the new coding system.

Although practices have had time to plan for the October 1, 2014, deadline, the Medical Group Management Association (MGMA) announced in mid-June that practices are still moving very slowly toward  compliance with the new coding requirements. There is a lack of communication and coordination between physician practices and their vendors regarding software updates and testing, and less than 5% of practices say they have made significant progress toward their overall readiness for ICD-10 implementation, MGMA says.

“The transition to ICD-10, with its substantial impact on documentation of clinical care, physician productivity and practice reimbursement, is unprecedented,” says Susan L. Turney, MD, MS, FACMPE, FACP, MGMA president and chief executive officer. “It is proving to be one of the most complex and expensive changes our healthcare system has faced in decades.

Adding to the implementation challenge and clearly taxing all stakeholders, ICD-10 will arrive at the same time that  several other transformative federal policies go into effect, such as health insurance exchanges and Stage 2 of the Centers for Medicare and Medicaid Services (CMS’) Meaningful Use EHR (electronic health record) Incentive Program.”

MGMA notes that roughly half of the physicians it recently surveyed had not heard from their practice management or EHR vendors about software updates, only about 5% had started internal testing of their programs, and almost 60% haven’t heard from their clearinghouse regarding external testing dates. According to an implementation timeline created by CMS, practices should have begun testing their new coding systems as early as March 2013.

Uncertainty in their ability to transition to ICD-10 by the October deadline has many physicians wondering if they will be paid for the care they provide after October 1. In fact, 60% of physicians say they are “slightly” or “not at all confident” that they will meet the compliance date, according to MGMA. More than 80% are also concerned about the clinical impact of the changes, with nearly 88% expressing fears about loss of clinician productivity after implementation, and about 81% worried about the overall cost of the switch. Only about a third of the respondents said vendors covered their costs to upgrade or replace practice management systems.

According to MGMA, the cost for a 10-physician practice to upgrade or replace practice management and EHR software is about $200,000.

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