ICD-10 at six months: Contributors and payers have still to reach the bottom

The major worrying about healthcare coming to a grinding halt on the day of Oct. 1, 2015 ICD-10 compliance target time didn’t materialize. The transformation went so well, instead, that it even has few healthcare experts uneasy.

Several health IT experts credited the awareness, preparation and education, as well as distinctive technologies for serving the transition, as reasons it has gone so smoothly, thus so far.

There were the proposed hiccups, no doubt, but for the most part they were small. Not shockingly, the physician region experienced the most complication at crunch time, with few practices attempting to make the conversion.

Broadly speaking, although, the transition was not as difficult as many persons hoped it to be," stated Mary Jean Sage, president of The Sage Associate.

For Jose Rivera, proposed vice president of physician solutions establishment at Santa Rosa, Calif.-based VisiQuate, the primary key to success was 2 and a half years of preparation.

"Previously we had a minor difficulty, maybe a 15% increase in claims that were held back for coding reviews because few physicians took a little longer to decide he accurate ICD-10 codes, but within a month it was back to normal and overall it was a victory," he emphasized.

To be really certain, the additional year made a difference for various healthcare agencies, stated Pauline O'Dowd, senior director with Chicago-based Huron Healthcare.

"Persons woke up on the day of Oct. 2 and founded that all was running well," she asserted. "From a clinical documentation view point, we discovered that persons were well prepared. We really have not seen any revenue drops ― there were the usual refusals, but nothing straightly linked to ICD-10."

While it is eager to think that the healthcare industry pretty much aced the ICD-10 target time, and those worries have been put to rest, the six month mark is a great time to inquire if such concerns actually have been settled?

The one-year time between Oct. 1, 2015 and Oct. 1, 2016, after all, is something of a grace period during which the CMS (Centers for Medicare and Medicaid Services) and commercial payers are giving more latitude on the intended claims descriptions.

"The bottom hasn’t been received yet because CMS came along and said it would not be as tough on physicians for twelve months after the deadline,” Sage stated. “There have not been too many refusals yet, but that could modify. So we might not have observed things that we will see after the day of Oct. 1, 2016.”

At least this far in the terror of massive claims denials; crashing cash flows and full-blown chaos were majorly unfounded. And after an emerging pre-target time build-up and "sky is falling" admonishments ― coupled with head-in-the-sand physician refusal ― it is no wonder that those terrors existed in the 1^st place.

Huron Healthcare’s O'Dowd claimed preparation, pragmatism, and prioritization assisted a lot of entities withstand the storm: "The agencies that succeeded constructed a powerful relationship with their teams ― particularly the clinical documentation specialists, physicians and coding experts."

But as the relaxation time winds down, contributors will have to get more particular with their codes, stated the director of product and portfolio analysis at Availity, Matthew Ketterman.

"Contributors understand that ICD-10 is life now," he claimed. "There may be certain problems with the network upgrades where no more ICD-9 codes are supported by the proposed vendors."

October 1, 2016 might result out to be the actual ICD-10 compliance target time.

"There is a lot of change to come,” stated Allison Gilmore, principal data scientist for healthcare with Menlo Park, California-based Ayasdi. “And we have yet to analyze the other proposed shoe drop.”