ICD-10 Delay Survey Reveals Concerns Around Economics And Workflow

By Megan Williams, contributing writer

Even with the extension of the ICD-10 implementation deadline, some healthcare providers are anxious about the process.

The American Health Information Management Association’s transaction processing management and testing vendor, Edifecs, released a survey that polled industry stakeholders between May and June of 2014 on what effects they expected to see from the transition to ICD-10 code sets.

Survey Details

The survey included 349 respondents, of which 101 were clinics or physician practices, and 115 were acute care hospitals or integrated health care delivery systems. Respondents also included vendors, payers, consulting firm representatives, and others.

Key Findings

Key findings of the survey relate to testing plans, potential workflow interruptions, economic impact, training, difficulty of clinical documentation, and code specificity.

• Testing Plans. Most organizations are prepared, with 40 percent of respondents indicating that they would begin end-to-end testing by the end of this year. Another 25 percent indicated they would by the end of 2015. For those who reported they had no plans to perform end-to-end testing, 41 percent indicated they did not know how to do so.
• Potential Workflow Interruptions. Many healthcare providers are concerned about how the code change will impact workflow, productivity, and revenue. A miniscule 6 percent believe that revenue will increase as a result of the change, while 38 percent believe revenue will decrease, and 14 percent believe it will remain neutral.
• Concerns Around Economic Impact. Despite concerns about economic benefit, heathcare providers overall are optimistic that the increased specificity that the code set brings can potentially improve research, population health management, and quality/performance measurement and improvement. At the same time, they answered that common activities including coding patient encounters, adjudicating reimbursement claims, and negotiating contracts between health plans and healthcare providers will likely be more difficult in the short term. Still, in the long-term, the transition is expected to improve metrics like claim accuracy, care quality, and patient safety. Unfortunately, not all organizations have a clear plan to extract value from the transition to the expanded code set.
• Opportunity For Additional Training. Healthcare providers also plan to take advantage of the one-year delay to perform additional training — 68  percent plan to conduct additional training and 31 percent have plans to hire additional coders to help with the transition.
• More Difficult Clinical Documentation. Clinical documentation is expected to be more difficult. Of all the tasks that change with the upgrade, respondents indicated that they expect the transition to cause problems around clinical documentation, particularly around coding patient encounters. Healthcare providers plan to use the extension to improve the integrity of clinical documentation.
• Improved Code Specificity. Lastly, healthcare providers expect to see benefit from leveraging the increased code specificity for claims processing and billing (65 percent), performance measurement (51 percent) and quality improvement (62 percent).