Results of the third semi-annual HIMSS ICD-10/5010 Readiness Survey show a majority of health care providers have made significant progress in preparing for the 5010 compliance, the latest version of standards for the conversion of electronic health records (EHRs). The deadline for 5010 compliance is Jan. 1, 2012.
“Many health care providers are making great strides in the last six months,” said John Casillas, HIMSS Senior Vice President, Business-Centered Systems. “While only 38 percent had a 5010 implementation plan in place in May 2010, by December, that number had jumped to 52 percent.”
However, one third report they either don’t have a plan for testing, or won’t test until the fourth quarter of this year.
“Although there is understandably quite a bit of competition for health care providers’ resources and attention, addressing 5010 compliance must be a priority,” said Joe Miller, one of the primary survey authors and former chair of the HIMSS Medical Banking and Financial Systems Committee. “Health care providers would do best to avoid the fourth quarter for testing, when payer and clearinghouse resources will be taxed to the limit. The result could delay or negate their receiving payment.”
According to the survey, 66 percent of organizations plan to upgrade their systems and 19 percent will use a clearinghouse. Nearly a third (30 percent) plan to start testing with their trading partners (such as payers) in the first quarter, 33 percent in the second and third quarters, and a third (33 percent) plan to test in the fourth quarter, or don’t know when they will test.
Survey respondents named the following as obstacles to testing: payers not ready (67 percent); competition for resources (53 percent); vendors not ready (50 percent) and clearinghouses not ready (47 percent). Other projects topped the list of competing initiatives, with 66 percent citing implementation of meaningful use of electronic health records.
Due to government incentives to adopt meaningful use EHR technology, many health care providers are focusing their energies on adoption of those initiatives. In fact, He said the soon-to-be-released second phase of meaningful use will focus on reporting patient data, suggesting likely synergies between 5010/ICD-2010 if planned correctly.
5010 is the latest version of healthcare transaction standards, focusing on the electronic exchange of administrative and financial information between health care providers and health plans for patient care services, including eligibility inquiries, service (treatment) authorization and referrals, claims status requests, claims and remittance advice (claims payment).
These updated transactions also play a critical role in the future of the International Statistical Classification of Diseases and Related Health Problems 10th Revision, better known as ICD-10, the largest overhaul in health care in the last 30 years. The World Health Organization has mandated that all U.S. hospitals must be using the revised system of coding diagnoses and procedures by Oct. 1, 2013. ICD-10 uses more than 155,000 different codes, a significant expansion from 17,000 codes available in ICD-9. Health care providers must have fully implemented their 5010 plans by Jan. 2, 2012 to avoid delays in claim reimbursement.
HIMSS received 256 usable survey responses from hospitals and integrated delivery networks (69 percent), practices and clinics (18 percent), and other providers such as long-term care facilities (13 percent).
Attend the ICD-10 Symposia during the HIMSS11 Medical Banking Institute on Sunday, Feb. 20, from 8:30 a.m. – 5 p.m. at the Orange County Convention Center.
Read more about the survey results on the HIMSS Medical Banking Project website.
Register for HIMSS Medical Banking Institute at HIMSS11.
About HIMSS
HIMSS is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare. Founded 50 years ago, HIMSS and its related organizations have offices in Chicago, Washington, DC, Brussels, Singapore, Leipzig, and other locations across the United States. HIMSS represents more than 30,000 individual members, of which two thirds work in healthcare provider, governmental and not-for-profit organizations. HIMSS also includes over 470 corporate members and more than 85 not-for-profit organizations that share our mission of transforming healthcare through the effective use of information technology and management systems. HIMSS frames and leads healthcare practices and public policy through its content expertise, professional development, and research initiatives designed to promote information and management systems’ contributions to improving the quality, safety, access, and cost-effectiveness of patient care. To learn more about HIMSS and to find out how to join us and our members in advancing our cause, please visit our website at www.himss.org.
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