by Loren Bonner
, DOTmed News Online Editor | June 26, 2013
Very soon, all health care facilities in the U.S. will need to abide by new codes to report medical diagnoses and inpatient procedures for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). On October 1, 2014 ICD-9 with be replaced with ICD-10 code sets — the 10th revision of the International Classification of Diseases.
The transition has been met with trepidation, and according to new research from Medical Group Management Association (MGMA), the overall readiness of the industry to meet the compliance deadline continues to be slow. DOTmed News spoke with MGMA president, Dr. Susan L. Turney, to learn more about what's happening with this important transition.
DMN: Why should we be paying close attention to ICD-10 right now with it over a year away?
ICD-10 is arguably one of the most complex and expensive transitions the health care industry has faced in decades. There are a large number of stakeholders involved, yet only some of them are required to make this change under the law. Physician practices are working with a wide array of trading partners for assistance as they implement this new code set. As the previous HIPAA implementations have shown, there never seems to be sufficient time to make the required software upgrades, train staff, internally test systems and workflow, and work with external trading partners to establish and complete testing processes.
By conducting this research well in advance of the Oct. 1, 2014 compliance date, we seek to both establish a readiness benchmark that we can use as a foundation for additional research (allowing us to access industry improvement on an ongoing basis) and to signal to both government and the private sector areas of concern well in advance of the compliance date that will hopefully steer the allocation of outreach and educational resources.
DMN: Why did MGMA decide to conduct research on the industry's readiness for ICD-10? What did you find?
We created the Legislative and Advocacy Response Network (LEARN) several years ago as an instrument to quickly and effectively measure and quantify responses from practice professionals to critical issues. We were very effective in communicating industry readiness levels in the run-up to the Jan. 1, 2012 compliance date for HIPAA 5010. Our data showed significant portions of the industry lagging behind and disruption to practice cash flow as a likely result. We aggressively publicized our findings and believe that they were at least partially responsible for the CMS decision to issue a six-month enforcement delay for 5010.