ICD-10 Readiness Survey Shows Industry Not Ready

ICD-10 readiness information collected from 2,600 providers, health plans and vendors indicates that the industry would not have been ready on time for ICD-10 according to the Workgroup for Electronic Data Interchange (WEDI) (requires login).  WEDI submitted the report to CMS on March 19, 2012.

50% of the provider community hasn’t completed an impact assessment, one third of providers won’t begin external testing until 2013, one fourth of health plans haven’t completed their ICD-10 assessment, and only about half of all HIT vendors have completed modifications to their software to support ICD-10.

From an ICD-10 implementation consulting perspective, HIPAA covered entities should be continuing to move ahead on their ICD-10 transition and interoperability plans.

The CMS delay in the ICD-10 transition should be used wisely.  Rather than be a license to start the process later, organizations should use the time to have extended testing (which also further builds competency), establish good governance and policies, metrics, develop good vision and strategy which before might just have been we have to comply instead of this is what we can do strategically.  It’s also a good time to review and improve processes and see if there are opportunities to streamline or change some roles, and engage third parties in those discussions.

Michael F. Arrigo

Michael is Managing Partner & CEO of No World Borders, a leading healthcare management and IT consulting firm. He serves as an expert witness in Federal and State Court and was recently ruled as an expert by a 9th Circuit Federal Judge. He serves as a patent expert witness on intellectual property disputes, both as a Technical Expert and a Damages expert. His vision for the firm is to continue acquisition of skills and technology that support the intersection of clinical data and administrative health data where the eligibility for medically necessary care is determined. He leads a team that provides litigation consulting as well as advisory regarding medical coding, medical billing, medical bill review and HIPAA Privacy and Security best practices for healthcare clients, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, physician compensation, Insurance bad faith, payor-provider disputes, ERISA plan-third-party administrator disputes, third-party liability, and the Medicare Secondary Payer Act (MSPA) MMSEA Section 111 reporting. He uses these skills in disputes regarding the valuation of pharmaceuticals and drug costs and in the review and audit of pain management and opioid prescribers under state Standards and the Controlled Substances Act. He consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises ERISA self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $8 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, studies at Stanford Medical School - Biomedical Informatics, studies at Harvard Medical School - Bioethics. Trained in over 10 medical specialties in medical billing and coding. Trained by U.S. Patent and Trademark Office (USPTO) and PTAB Judges on patent statutes, rules and case law (as a non-attorney to better advise clients on Technical and Damages aspects of patent construction and claims). Mr. Arrigo has been interviewed quoted in the Wall Street Journal, New York Times, and National Public Radio, Fortune, KNX 1070 Radio, Kaiser Health News, NBC Television News, The Capitol Forum and other media outlets. See https://www.noworldborders.com/news/ and https://www.noworldborders.com/clients/ for more about the company.

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