Why Physician Practices Are Slow to Switch to ICD-10

Is your practice procrastinating in its preparations for ICD-10?  If so, you’re among the majority. 

When it comes to making a big jump from ICD-9 to ICD-10, for which compliance will go into effect Oct. 1, 2014, only about five percent of physician practices have made significant progress. And that’s not the only concerning nugget of data the Medical Group Management Association (MGMA) unearthed in its survey of 1,200 medical groups.

As iHealthBeat noted, the shift from ICD-9 to ICD-10 code sets means that healthcare providers and insurers will have to swap 14,000 codes for about 69,000 codes.

The transition, which will require physician practices to work with their vendors (EHRs, clearinghouses, etc.) to make sure technology is upgraded and tested, is fraught with financial and operational anxiety. According to MGMA, 55 percent of survey respondents said they are “very concerned” about the cost of transitioning from ICD-9 to ICD-10. Sixty percent of respondents said their EHR will need an upgrade, and five percent said their EHR will need to be replaced, according to the survey.

In terms of clinical productivity, seven out of ten practices are concerned about losing it post-transition. Seventy-five percent of practices believe it will become “much more difficult” for clinicians to select the appropriate diagnosis code. 

These data don’t surprise Jim Denny, CEO of claims clearinghouse Navicure.

“Most practices today are doing whatever they need to do to keep their businesses running,” Denny told Physicians Practice. “Like 5010, ICD-10 puts a strain on the practice. Doctors are going to have to get familiar with the new code set, the billing staff will have to become conversant with the new codes, the payers will change what they do in terms of processing insurance claims … and reconciling payments with the new codes, some of that will change as well.”

To assuage such fears for its physician practice clients, Navicure is doing a number of things, such as offering high-level webinars so they can better understand the ICD-10 transition, as well as bolstering its support-desk staff.

According to the MGMA survey, 53 percent of practices have not heard from their practice management vendor on when they plan to make the ICD-10 upgrade or replacement available. Half of respondents said they have not heard from their EHR vendor on when it will make the upgrade. Denny recommends that practices reach out to their vendors to figure out their timeline for making the transition.

“It starts with a plan,” he says. “You should define when you start the transition process; you should talk about when you can educate your physicians and coders. What you don’t want to do is wait until the last minute to make the transition.”