ICD-10 Readiness: Physician Practices Lag Far Behind Hospitals

Hospitals did not get any ICD-10 relief as part of CMS’ accord with the AMA regarding a specificity grace period. However, they might not need much help, according to the latest Workgroup for Electronic Data Interchange (WEDI) survey.

Approximately 88% of hospitals that responded to the survey expect to be ready for ICD-10 by implementation, with only one respondent anticipating not being ready and 10% unsure.

Physician practices fared worse on this question. Less than 50% said they would be ready, with nearly 25% said they would not be ready and more than 25% are unsure. WEDI conducted the survey of 453 providers, 96 health plans, and 72 vendors in June.

Physician practices also lagged in testing, with approximately 20% in some stage of external testing with vendors compared to nearly 75% of hospitals.

Hospitals are taking advantage of CMS’ end-to-end testing weeks and ongoing acknowledgment testing far more frequently than physician practices. Approximately 60% of hospitals have tested with Medicare, while less than 17% of physician practices have taken the same step.

Another concern is the number of providers planning to use crosswalks to produce ICD-10 codes instead of coding directly. Less than 20% of hospitals plan to use crosswalks, but nearly 66% of physician practices plan to use them. While crosswalks are a helpful tool for coding, they’re not meant to replace native coding.

The survey isn’t all bad news. Vendors are increasingly ready for ICD-10, with 75% reporting their software and services are ready, a big increase from less than 60% in the February 2015 survey. No vendors reported their products would not be ready by implementation.

Another important piece of news is that uncertainty is no longer the leading obstacle to implementation, as it was in the February survey. Fewer providers, health plans, and vendors cited uncertainty as a top concern, meaning that organizations are finally recognizing that ICD-10 is coming and the best thing they can do is prepare.

CMS’ guidance regarding specificity should assuage some fears for physician practices, but it doesn’t mean they can ignore ICD-10, especially since other payers may require specific codes and those codes may be required to meet Local and National Coverage Determination requirements.

While the survey shows the industry more prepared than ever for ICD-10, the hardest work may still be ahead for many organizations.

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