Steep climb to ICD-10 readiness

Practices face steep climb to ICD-10 readinessPhoto used with permission from

How far along in the ICD-10 preparation process is your practice? If you've developed a plan of action, you're ahead of the game, comparatively speaking. According to the recently released Physician Practice ICD-10 Readiness Survey from medical claims clearinghouse Navicure, only about 19 percent of practices have established such a plan.

It's more likely, however, that your practice status falls in line with the 54 percent of respondents who have either not yet started preparing for ICD-10 or who feel like their plans are not on track to meet the Oct. 1, 2014 transition deadline.

Navicure commissioned Porter Research in April 2013 to conduct the survey among physician practices nationwide. More than 500 practices responded, reflecting a range of specialties and sizes (from solo practitioners to groups of 50-plus providers). Navicure noted that more than 80 percent of respondents were practices with less than 25 providers.

Only about 12 percent of respondents have initiated their plan and are on track for implementation, Navicure reported. About 10 percent have briefed their team of developed roles/ responsibilities for implementation.

Why aren't more small practices up to speed -- or at least in preparation mode?

"This is a very big project, and they're really trying to take a breath after dealing with meaningful use and the HIPAA 5010 transition," explained Ken Bradley, Navicure's vice president of strategic planning, in an interview with PhysBizTech. "I think it now has their attention, so that's a good thing because this is not only an IT update, but it's a people update, too."

Bradley said his company's approach in working with small practices has been to "slice up this enormous undertaking into smaller chunks to make it more doable." Navicure has been presenting monthly webinars that isolate for practices the different aspects of the transition.

"You have to start with a high level view of ICD-10 and how it differs from ICD-9 so you can scope it and begin to understand how it's going to impact your office," said Bradley. "From there, you can begin to work on physician and management buy-in, and then work into doing an inventory of where diagnosis codes are used."

At the same time, Bradley cautioned the 36 percent of practices who, according to the survey, have not started preparing for ICD-10 because they believe they still have more time. "It's true that CMS [the Centers for Medicare & Medicaid Services] has had a history of pushing deadlines, but this one has already been pushed out one year. The chances of another delay are probably pretty low. Nevertheless, a fair number of practices still feel that it's going to be delayed again. That's a significant risk to your practice revenue -- on a potential event that may not happen."

He added, "We suggest the best approach is to be ready for the deadline as it exists on Oct. 1, 2014.

Also noteworthy among the findings: Forty-three (43) percent of practices anticipate a productivity drop of less than 20 percent from ICD-10, and 33 percent expect the drop to average closer to 21 to 40 percent.

"That concerns me, said Bradley, "because many practices exist week-to-week or month-to-month with their revenue. There's a real possibility that productivity is going to be impacted significantly for some time after the Oct. 1, 2014 deadline. It's better to be more prepared than underprepared. The revenue stream is very critical for practices that may not have a big cash cushion. We know that the 1-10 provider practice size is probably the least prepared when it comes to that."

Navicure's survey report said practices should re-evaluate the role of technology systems in mitigating cash flow interruption. In particular, practice management systems and clearinghouses can assist by:

  • providing/participating in end-to-end testing to ensure complete system readiness; and
  • minimizing cash flow interruptions by identifying and fixing and issues that arise during testing and ICD-10 implementation.

However, the report said, vendor technology updates are only part of the ICD-10 process; much of the responsibility for the transition rests on practices. And, of course, all practices are different in terms of the combinations of software used as well as the levels of understanding and job functions within the practice structure. "Plan for this uniquely to your practice," Bradley advised.

He concluded, "If you haven't started, you've got to start now. Dedicating smaller amounts of time over a longer period of time is the best approach. You just won't get this done three months before the deadline. Resources are going to be tight immediately preceding that deadline. Trying to get education and other assistance will be nearly impossible if you haven't thought it out and scheduled it in advance."

Click here to access the report.

Photo used with permission from