News Feature | October 22, 2013

ICD-10 Testing Pilot Was "Scary"

Source: Health IT Outcomes
Greg Bengel

By Greg Bengel, contributing writer

After two rounds of end-to-end ICD-10 testing, one provider group is alarmed at the levels of inaccuracy and the decrease in productivity

More bad news on the ICD-10 implementation front.

The North Carolina Healthcare Information and Communications Alliance (NCHICA) have conducted two rounds of end-to-end ICD-10 testing. How to describe the results? Holt Anderson, executive director of NCHICA called them “scary” when talking to the Medical Group Management Association (MGMA) last week.

According to Fierce Health IT, results from the first test were only 55 percent accurate for 20 dual-coded and peer reviewed scenarios. There was a slight improvement – the second test saw 63 percent accuracy.

However, worker productivity dropped by a startling 50 percent. Coders went from averaging four medical records per hour with ICD-9 to only two records per hour with ICD-10. Anderson is quoted on this decrease in Government Health IT. He incredulously asks, “Can you lose that kind of productivity?”

According to the Government Health IT article, the people tested were considered top coders. “We selected some of the best of the best coders in these organizations," Anderson is quoted as saying. After peer review, it was discovered that these top coders were not even coding correctly in ICD-9, let alone in ICD-10.

Anderson’s advice for providers? This is a cash flow issue, he says. Providers need to “group up” and “get on it.” He has reason to be alarmed. Government Health IT points us to a June MGMA study that found that 55 percent of physicians have not begun ICD-10 implementation.

Government Health IT also points out that the issue is more prevalent among smaller practices. The article reads, “Larger healthcare organizations with the financial wherewithal to move aggressively forward with ICD-10 get it. They’re allocating the resources and getting the staff they need.”

Much has been written on how to make transition to ICD-10 smoother. These larger organizations that “get it” might be another good place to look for advice. Healthcare Finance News recently ran an article called, “5 lessons from ICD-10 transitions at large hospitals.” Check out the article for more detailed advice. The five lessons, briefly, are embrace technology, hire help, practice claims, convert ICD-9 codes in research to ICD-10 codes, and to collect data of what is “normal” with ICD-9 coding to compare once claims with ICD-10 codes are rejected.