ICD-10 Provider Readiness Survey Results, November 2012

contents purpose demographic of respondents demographic of specialty type key findings & recommendations next steps survey highlights by provider type

purpose In 2012 from mid-November to mid-December, an ICD-10 Provider Readiness Survey was sent out to Blue Shield of California’s (Blue Shield’s) physician and provider network to assess key indicators for ICD-10 adoption on October 1, 2014. Survey findings from 2012 yielded two key themes which we will outline in further detail in subsequent slides. They are: Providers reliance on practice management systems to select ICD-10 codes. Providers’ concern regarding ICD-9 to ICD-10 translation or mapping, versus their ability to send a compliant claim

survey response demographics: provider type *Fax & postal mail outreach results were excluded, due to a .5% response rate.

survey response demographics: specialty type

survey results findings- electronic medical records (eMR) Of the PPO providers who responded: Providers are relying heavily on the functionality of the practice management system to aid in transitioning medical records to ICD- 10 coding. Blue Shield’s recommendations We recommend that in addition to using practice management systems for electronic medical/health records, that you make a separate effort to educate, train, and certify your coding/billing staff. Or, verify that your billing service is planning to have their staff certified in ICD-10 CM and PCS code sets. We also recommend assessing your coding/billing staff’s competency in ICD-9 Clinical Modification (CM)to learn how to tailor the ICD-10 CM training plan as a best practice. Since the ICD-10 Procedure Coding System is new, training and review of all associated medical policies is also strongly recommended.

survey results findings- ICD-9 to ICD-10 mapping Of the PPO providers who responded: Providers are more concerned with ICD-9 to ICD-10 mapping and translation tools versus their ability to send a compliant claim. Blue Shield’s recommendations We encourage you to participate in testing opportunities, when possible. If your practice/facility is unable to test directly with Blue Shield, we also recommend that you consider joining the ICD-10 California Collaborative. Their aims is to bring stakeholders in the healthcare together to address ICD-10 related challenges and to develop best practices for communication/outreach, education/training, and testing.

Next Survey May 2013 provider survey next steps Work with specialty professional associations to reach out to providers listed in the demographic section (slides 4-5) to encourage and increase survey responses. Blue Shield of California is a founding member and holds leadership roles within the CA ICD-10 Collaborative, which aims to bring stakeholders in the healthcare together to address ICD-10 related challenges and to develop best practices for communication/outreach, education/training, and testing. Next Survey May 2013

Appendix- Survey highlights by provider type

survey highlights- ancillary groups 25% of Ancillary groups have implemented an eMR system Of the 75% of Ancillary groups that do not have an eMR system, 40% will have implemented an eMR by the October 1, 2014 date. Ancillary group’s concerns regarding obstacles to ICD-10, rank order: Understanding code use in billing- 45% Costs related to implementation- 20% System programming implementation in time for compliance-15%

survey highlights- clinics 5% of Clinics are not very confident they will be ready by October 1 2014. 39% of Clinics have implemented an eMR system Of the 61% that do not have an eMR system, 41% will have one implemented by the October 1, 2014 date. Clinic’s concerns regarding obstacles to ICD-10, rank order: Understanding code use in billing- 48% Costs related to implementation- 24% System programming implementation in time for compliance-16%

survey highlights- providers 15% of respondents are rural providers. 67% of rural providers plan to send all or 50 – 100% claims electronically by October 1, 2014. 95% of respondents are in groups of less than 5 practitioners. 27% of providers have not started planning or implementation for ICD-10. 36% of Practitioners have an EMR system. Of the 35% of practitioners that do not have an EMR, 48% are planning to implement EMR by October 1, 2014. 68% of providers who responded plan to send 50-100% of claims electronically by October 1, 2014. Provider’s concerns regarding obstacles to ICD-10, rank order: Understanding code use in billing- 45% Costs related to implementation- 15% System programming implementation in time for compliance-11%