Plenty of hurdles ahead for ICD-10 conversion
ICD-10 compliance deadline still two years off, but plenty of hurdles remain for providers, vendors
It’s two years now and counting down, until Oct. 1, 2013. That’s when, according to experts, the information technology sector of the U.S. healthcare industry must make, quite possibly, its biggest lift ever— ready or not. “It’s a big, big date,” says health IT consultant Stanley Nachimson. “Bigger than Y2K or 4010 or 5010 or any of the HIPAA implementations. It will impact everything from patient registration to reporting. It’s a big deal.”
Nachimson should know. The principal of Nachimson Advisors, a health IT consultancy, is a former senior technical adviser for health IT activities at the CMS. The “it” he’s talking about is the CMS-mandated conversion from the International Classification of Diseases Ninth Revision, or ICD-9 family of diagnostic and procedural codes in current use, to the far larger and more complex ICD-10 code family.
Before the long-awaited switch to ICD-10 happens, the industry will have jumped through a steeplechase of other technical and organizational hurdles. And it’s been a long process: the run-up period between the CMS publication of its final rule for ICD-10 in January 2009 and the compliance deadline is more than 56 months.
The hurdles include completing by Jan. 1, 2012, the prerequisite and aforementioned CMS-mandated conversion from the ASC X12 Version 4010 claims transaction standards to the more robust Version 5010 needed to handle claims using the ICD-10 codes.
A far more painful challenge for lots of providers before the ICD-10 switch will be the clearing of the many meaningful-use criteria set by the CMS for the Medicare electronic health-record incentive program under the American Recovery and Reinvestment Act of 2009.
Through August, fewer than 2,300 hospitals, physicians and other “eligible professionals” have cleared Stage 1 meaningful-use standards and been paid, according to the CMS. A gold rush of providers is expected to join the program in 2012.
To do that, many provider organizations will be forced to install and meaningfully use new, certified EHRs. And then by Oct. 1, 2013, the first group of meaningful users could be forced to implement EHR upgrades to comply with more stringent Stage 2 criteria. Health plans and claims clearinghouses, meanwhile, must upgrade their IT systems for 5010 and ICD-10.
So, with such a full load of other IT projects, how is the industry faring with its preparations for ICD-10?
It depends on whom you ask. Nearly everyone contacted for this story says the industry as a whole is behind schedule, but the ICD-10 awareness level is rising among industry organizational leaders and there are even a few bright spots of what could be called a high degree of advance preparedness.
Meaningful use first
Dave Roach is vice president of information systems and chief information officer at Kadlec Health System, Richland, Wash. Kadlec operates a 201-bed hospital and runs 15 outpatient clinics.
Roach says members of the hospital’s coding team have been “going to conferences and webinars for ICD-10,” but for now, ICD-10 is not a top priority.
“We’re putting in new systems to meet