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For years, healthcare organizations worked to prepare for the transition from ICD-9 to ICD-10. Some predicted the results of implementing such a huge code set would be catastrophic and hold little clinical value. Others asserted that this merely would be another Y2K-like experience that would turn out fine despite concerns.
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Now that the ICD-10 implementation date of Oct. 1, 2015, has passed, and payers and providers have been dealing with the new code set for two months, two industry sources agree that the transition was not catastrophic.
"It's gone much smoother than we had [anticipated]," said Robert Tennant, health information technology policy director at Medical Group Management Association (MGMA), based in Englewood, Colo. He previously had predicted that ICD-10 would not go over well in the healthcare community and still stands by the assertion that there is scarcely any sign that ICD-10 has any clinical value.
Regardless, he reported that he has heard very little from MGMA members in terms of rejected claims, especially on the commercial side.
And Melanie Endicott, director of HIM practice excellence at the American Health Information Management Association, based in Chicago, has found the same results.
"The few incidences I've heard is because of some LCDs or NCDs -- those are local coverage determinations and national coverage determinations; they're edits that are built in from Medicare, and some of those don't seem to have been updated for ICD-10 codes," Endicott said.
Tennant has also heard about people encountering issues with LCDs. However, he said CMS has announced that they're trying to fix these issues as soon as possible.
CMS averted some of the panic
Despite this, most providers seem to be doing fine. So, was this transition actually a Y2K-type of occurrence?
"I think the answer is no," Tennant said. "I think, partly, the answer is what happened in early July, which is the announcement by CMS that they were going to add flexibility to the claims process."
Tennant believes this sent a signal to three stakeholders that would be greatly affected by the transition from ICD-9 to ICD-10: Congress, practice management and EHR vendors, and healthcare providers.
By announcing this flexibility, "[CMS] deflated a number of efforts within Congress to modify ICD-10," Tennant said. "Whether it be to accept both code sets or delay, it sort of took the wind out of the sails of those folks on [Capitol] Hill."
Robert Tennanthealth information technology policy director, MGMA
For the practice management and EHR vendors, this announcement officially signaled to them that the transition from ICD-9 to ICD-10 was, ready or not, going to happen on Oct. 1.
"It gave them sort of a hard date to work towards," Tennant said. And the same is true for providers who, once they realized the switch was truly happening, "put their nose to the grindstone."
He added that, "I think the end result was [providers] got ready because ... this is the life blood of the practice. If you don't get your claims paid, you don't stay in business."
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