Plenty of hur­dles ahead for ICD-10 con­ver­sion

ICD-10 com­pli­ance dead­line still two years off, but plenty of hur­dles re­main for providers, ven­dors

Modern Healthcare - - MODERN HEALTHCARE - Joseph Conn


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

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