ware costs, they report an average cost of $11,500 per full-time physi- cian and $12,885 for the electronic health record (EHR) system.
• Internal software testing is lagging. Only 8.2 percent stated they have be- gun or have completed testing with their EHR vendor, compared with 4.7 percent in June. Slightly more than 10 percent of respondents reported in- ternal software testing had begun or
is complete with their practice man- agement vendor.
• External communication and testing have been delayed. In June, 70 per- cent of respondents stated they hadn’t heard from their major health plans regarding the date on which ICD- 10 testing would begin. Six months later, nearly 60 percent said they still hadn’t heard. Only 5.4 percent re- ported that they had begun testing
with their major health plans. The number of respondents who indicated concern about the expected changes to clinical documentation remained constant at about 89 percent.
The Centers for Medicare & Medicaid
Services (CMS) mandated the ICD-10 diagnosis code set for use by physician practices, other practitioners, clearing- houses, and health plans. With ICD-10 containing more than five times the number of codes as ICD-9 and incorpo- rating a completely different structure, the new code set will require extensive changes for medical groups. Meanwhile, a new report commis-
TMA helps you prepare for ICD-10
With ICD-10 implementation just six months away, your medi- cal practice has some serious preparation to do. Staff members need hands-on, detailed training to make ICD-10 work in the practice. TMA’s newest statewide seminar series, ICD-10 Docu- mentation and Auditing: Success Is in the Details, delves into how to use the new ICD-10-CM code book and its guidelines and how to audit physician documentation in day-to-day practice. Register for the seminar online,
http://bit.ly/1jqFDYr. In addition, ICD-10 Now! How and Why, an on-demand webi-
nar from TMA, offers a detailed look at everything you need to know and do to prepare for ICD-10. TMA’s on-demand webinar ICD-10 Starts With Physicians targets physicians, office manag- ers, and coders. It highlights the ICD-10 transition process, code structure, and the impact of ICD-10 on a practice. Register for the webinars online,
http://bit.ly/1eOe5Ze. Be sure to bookmark TMA’s ICD-10 resource page, www
.texmed.org/icd10, for news, tools, education, updates, and the ICD-10 Readiness Questionnaire for Vendors from the American Health Information Management Association. The TMA Knowledge Center alert service will also keep you
up to date with the newest articles and latest developments on ICD-10 and other health care topics. TMA Knowledge Center staff have created custom searches on ICD-10 and other topics set to run weekly. Search results are emailed directly to you or accessed via RSS feed. TMA Knowledge Center alerts provide citations and abstracts along with some full-text access. Fill out the online form,
www.texmed.org/alerts, to sign up.
48 TEXAS MEDICINE April 2014
sioned by the American Medical Associa- tion says the costs for physician practices to implement the federally mandated transition to the ICD-10 code set are three times earlier estimates. Using the new report as ammunition,
AMA “strongly urged” U.S. Health and Human Services Secretary Kathleen Se- belius to “reconsider the mandate.” In a letter to the secretary, AMA Execu- tive Vice President James Madara, MD, wrote, “AMA policy adopted by our House of Delegates calls for repealing ICD-10 for the simple reason that it is not expected to improve the care phy- sicians provide their patients and, in fact, could disrupt efforts to transition to new delivery models.” (TMA was in- strumental in the AMA house adopting that policy.) The study, conducted by Nachimson Advisors, compared current estimates of ICD-10 conversion with Nachimson’s widely reported 2008 report. For a typi- cal small practice, the costs increased from $83,290 in 2008 to a range of $56,639 to $226,105 in 2014. Costs for a typical large practice jumped from $2.7 million in 2008 to a range of $2 million to $8 million this year. Reasons cited for the increase are the
previously unexpected need for the soft- ware upgrade and the significant “po- tential for increased payment disruption” after ICD-10 implementation. n
Crystal Zuzek is the editor of Texas Medicine. You can reach her by telephone at (800) 880-1300, ext. 1385, or (512) 370-1385; by fax at (512) 370-1629; or by email at
crystal.zuzek@texmed.org.
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