Four State Medicaid Programs Will Not Transition to ICD-10 by Oct. 1 - iHealthBeat

However, CMS will allow four states -- California, Louisiana, Maryland and Montana -- to use a "crosswalk" technique to continue using the older code sets for their Medicaid fee-for-service programs because their claims processing systems in these four states are unable to use the new ICD-10 codes.

What is good for the goose may not be good for the gander.

Even as CMS and HHS insist upon implementation of ICD-10 some state agencies will be unable to comply when the conversion date from ICD9 to ICD10 magically occurs throughout the rest of healthcare.

What is the reason, and how does it differ from the rest of  healthcare providers,hospitals, clinics, and individual physicians, who have struggled at great expense to meet the mandates of HHS and CMS.

Four state Medicaid programs have received CMS approval to delay fully transitioning to ICD-10 code sets by the Oct. 1 deadline to do so, Modern Healthcarereports.

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets by Oct. 1 to accommodate codes for new diseases and procedures.

According to Modern Healthcare, all HIPAA-covered entities are required to complete the transition.

Details of Technique

How will this be accomplished for these government entities?   Under the crosswalk technique, the Medicaid programs will convert claims using the ICD-10 system into ICD-9 codes to calculate payments.

CMS spokesperson Jibril Boykin said, "We have worked closely with each state to understand how they will mitigate any issues that may arise and minimize impact on the accuracy and timeliness of provider payments." However, he noted that the crosswalk technique is not "a long-term approach."

California Department of Health Care Services spokesperson Adam Weintraub said CMS allowed the state's use of the crosswalk technique when it approved funding for Xerox Health Systems' upgrade of California's Medi-Cal management information system. Xerox's proposal included using a coding crosswalk. The system was implemented in September 2014 and is still undergoing external testing.

Government HIT is even more obsolete than private legacy systems. Many must be replaced rather than patched. However given budgetary constraints, this will not occur for some time.   Weintraub said, "California is working on a (claims processing) system replacement effort which, upon implementation, will process natively using ICD-10," adding, "As an interim solution, Medi-Cal implemented ICD-10 on our legacy system utilizing a crosswalk in order to reduce the cost and system changes to an aging system that is being replaced."

California Hospital Association spokesperson Jan Emerson-Shea said, "We do continue to have some concerns about the use of the crosswalk approach and we'll be raising these concerns during a stakeholder meeting."

Andrew Boyd, assistant professor in biomedical and health information sciences at the University of Illinois-Chicago, said, "My biggest concern is delay of payment for hospitals and physician groups, because cross-mapping could result in a cash flow crunch on already narrow margin groups."

Meanwhile, Robert Tennant -- director of Health IT Policy at the Medical Group Management Association, which has sought to delay the transition to ICD-10 -- raised concerns about such readiness issues surfacing this close to the compliance date (Conn, Modern Healthcare, 9/4).

57% of Health Care Groups Not On Track for ICD-10, Survey Finds

Survey: Just 10% of Texas Doctors Confident About ICD-10 Transition    

Just 10% of Texas physicians said they are "very confident" their practices will be ready for the upcoming ICD-10 transition, according to a survey by the Texas Medical Association, Health Data Managementreports.

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets by Oct. 1 to accommodate codes for new diseases and procedures.

The survey, conducted in July, included responses from 936 TMA members and non-members, 42% of whom were solo practitioners.

Survey Findings

According to the survey, just 7% of physicians said they have started transitioning to ICD-10 extensively (Slabodkin, Health Data Management, 8/21). Meanwhile, 31% of respondents said they had not started the transition at all (Bresnick, EHR Intelligence, 8/19).

Among solo physicians, 82% said they have not started the transition at all or have made only limited progress (Health Data Management, 8/21).

Meanwhile, 42% of respondents said they are "not at all confident" that the implementation of ICD-10 will cause no serious disruptions (EHR Intelligence, 8/19).

For example, the survey found that:

• 83% of respondents expect the transition to result in delayed or denied claims;
• 36% expect to face disruptions that require them to draw from personal funds;
• 32% said they might reduce staff size, work hours or benefits; and
• 30% said they might retire early because of anticipated cash-flow issues related to the transition (Health Data Management, 8/21).

Further, the survey found that:

• 47% of administrative staff at primary care organizations and 40% of primary care physicians have participated in education or training related to the transition; and
• 33% of solo practitioners have received ICD-10 training or education.

Among respondents with electronic health record systems in place:

• 65% said they are capable of processing ICD-10 codes;
• 52% said their practice management software was capable of processing ICD-10 codes ; and
• 1% said they will need to completely replace their IT systems to comply with ICD-10.

Meanwhile, 29% of respondents without upgraded EHR software are expecting to implement new products soon (EHR Intelligence, 8/19).

Four State Medicaid Programs Will Not Transition to ICD-10 by Oct. 1 - iHealthBeat