Before you know it, the ICD-10 go-live date of October 2014 will be here, and for those 55 percent of physicians who have yet to begin implementation, it's looking like a rocky road ahead.
Speaking at the Medical Group Management Association's 2013 annual conference in San Diego in early October, Holt Anderson, executive director of the North Carolina Healthcare Information & Communications Alliance, shared his group's experiences with an ICD-10 end-to-end testing pilot.
Initial results? Just plain "scary," said Anderson. For starters, worker productivity decreased by 50 percent when attempting to identify the proper ICD-10 codes.
And Anderson considers NCHICA more ahead of the game than the rest. The group includes more than 300 member organizations and established its own coding task force back in 2010.
The pilot, he said, was started to see where coders were at and to share experiences with others in the hope of preparing more providers. "We know what 5010 should end up being paid," said Anderson. "We send it, and see how they adjudicate it and how it comes back. Did it match or did it not? Did the clearinghouse in between do anything?"
For 20 dual-coded and peer-reviewed scenarios, the initial results were 55 percent accurate, with many scenarios falling well below that. This was not a number Anderson, NCHICA and the participating pilot members were expecting.
"We selected some of the best of the best coders in these organizations," he said. When the peer review was done, they realized these top coders weren't even coding correctly in ICD-9, let alone ICD-10.
In the second phase of the pilot, the results were considerably better, averaging a 63 percent accuracy rate, said Anderson.
So far, the task force has conducted more than 200 highly relevant dual-coded and peer-reviewed scenarios, and another 100 scenarios are still in the process.
Not only was the coding proving inaccurate, it was taking about twice as long, added Anderson. Coders were averaging two medical records per hour with ICD-10 compared to four or more under ICD-9. Many cannot afford such a loss in productivity.
Larger healthcare organizations with the financial wherewithal to move aggressively forward with ICD-10 get it the importance of being prepared, Anderson. They're allocating the resources and getting the staff they need. But for smaller healthcare practices that don't necessarily have the resources, it's just worrisome. "We're not sure how aware they are," he said. They're more focused on meaningful use and getting their EHRs up to speed, he said, then in preparing for ICD-10.
At the end of the day, however, this is a major cash flow issue, he said, and providers need to "get on it."