ICD-10 testing strategy for 2014

With the delay in ICD-10 in late March 2014, there has been a general aura of unsettlement in the healthcare IT space, with providers being unsure on what is expected of them, and by when. In the AHIMA summit held in April 2014, 88% of the healthcare participants were unhappy with the ICD-10 delay and 50% wanted to start voluntary reporting of ICD-10 codes starting October 2014.

The global healthcare IT market is expected to grow to $50.4 billion by 2018. Transitioning to ICD-10 is a complicated process, which can gravely affect hospital working and overall functioning, so for this purpose, they rely on outsourced vendors who have the expertise and experience to shield their clients from grave errors.

In a recent survey of 650 hospital IT and physician leaders, it was noted that 19 % of the respondents indicated that they were outsourcing their coding work, and a whopping 47% claimed they will be outsourcing their coding work from October 1, 2015, following the switch to ICD-10.

Many providers remain unaware of how they will be going about implementation of ICD-10 and how to manage the new reimbursement process. And on the other hand, there are many providers who will be ready to proceed with end – to – end testing by end of this year, and a few who would be ready by end of 2015. The CMS plans to come out with a ‘national timeline’ which will entail details about when each stakeholder, be it a provider or a payer, needs to be ready for testing processes. This will also ensure that each stakeholder has tested the IT systems and done the necessary integrations to ensure a smooth functioning.

The strategy ahead:

• Continue testing and go live with all the technology as and when ready, to prevent unnecessary financial risks
• Complete testing and validation will have you in a much more comfortable position with only regression testing for 2015
• If not complete implementation of ICD-10 codes, a complete evaluation and testing in consensus with the finance department to ensure proper coding conversions
• Native coding from providers will also help to mitigate risks associated with inconsistent coding patterns till ICD-10 codes go live
• In case of consulting engagements, completing testing and implementation will have IT engagements stalled till 2015 for the last round of testing and going live. This can be beneficial financially too.

Hence, when looking at the effort which has been put into the conversion process, it would be most logical to go ahead with the testing and implementation process, and being ready much earlier than 2015. In 2015, regression testing and final transition alone, will ensure the best strategy for payers and providers alike.