Last summer when CMS announced yet another delay in implementation of the ICD-10 system, putting it off from October 2014 to October 2015, practices breathed a collective sigh of relief. At the time, a few apt experts predicted that the delay would give a dangerously false sense of security to those who were nowhere near ready. That seems to have been exactly what happened. According to survey results released this week by WEDI (Workgroup for Electronic Data Interchange), only 20 percent of physician providers have completed external testing.
When asked why so few practices had tested, Ken Bradley, vice president of strategic planning and regulatory compliance at Duluth, Ga.-based medical claims clearinghouse, Navicure said that it's not so much not wanting to test, as it’s the inability to do so According to a Navicure survey, fewer than half of practices surveyed have even completed installment of their EHR systems.
This may not be due to old-fashioned procrastination. "Many practices wanted to wait until it was clear that ICD-10 really was going to happen," said Bradley, adding that it’s perhaps understandable.
Preparation for ICD-10 has been a huge challenge for smaller practices. "I think practice administrators and physicians are on total overload," said Elizabeth Woodcock, president of Woodcock and Associates, a Fredericksburg, Va.-based physician practice consulting firm. "Think about it —the physician quality reporting system, meaningful use, EHR implementations, value-based payment modifier, let alone all of the commercial payers' initiatives. It's almost too much." Bradley adds that, "Putting time and money into things they know for sure are going to happen—such as meaningful use—seemed to many practices the only sensible way to allocate resources."
There may also be a tiny bit of the Pollyanna out there. "Y2K, 5010, etc., all caused hysteria in the industry, yet it all went without a hitch," said Woodcock. "I think this is what practices think about ICD-10—that it will be okay."
But is that confidence well-founded? Maybe. Even though many smaller practices haven't tested, the big payers have and for the most part, things went smoothly. Indications are that the electronic systems are going to work just fine (as long as providers have them installed and ready to go), but Bradley points out that ICD-10 is not just a tech update. "The biggest concern is getting the coding staff trained and ready," he said. On the other hand, CMS has agreed to give leeway for coding errors during the transition period, but if your systems just don't work, you're out of luck.
The testing question may be moot anyway. Many of the big payers have done enough testing and are not available for more testing with tardy practices. "Some practices may have to just do without testing," Bradley said.