National Pilot Program reports rocky first flight

Carl Natale
by Carl Natale

The National Pilot Program has completed its first round of testing. The results are less than stellar.

The National Pilot Program is a collaborative effort managed by the  Healthcare Information and Management Systems Society (HIMSS) and Workgroup for Electronic Data Interchange (WEDI). This pilot program was conducted from April through August. Healthcare providers coded actual, anonymous medical records. They were picked to represent the most common medical conditions.

[Download the report: ICD-10 National Pilot Program Outcomes Report]

Before we get into some of the findings, remember this is the first round of testing done more than a year before the ICD-10 compliance deadline. If it seems medical coders are unprepared, that shouldn't surprise anyone. This is why there is testing.

Note that this testing only involves healthcare providers. There wasn't time to get healthcare payers and clearinghouses involved. And those providers had trouble committing staff to participate in the exercise.

Here are the problems:

  • Accuracy varied depending on the type of medical condition documented. For example:
    • “Chest pain, unspecified” was coded accurately 34 percent of the time
    • Generally accuracy was at 63 percent
  • Test documents were scanned upside down.
  • Medical coders forgot to use procedure codes.
  • "O" and "0" were used improperly. The same issues were had with "l" and "1".
  • Productivity was reduced 50 percent to two medical records per hour.
  • Some medical records were not coded completely.

One of the tips that came out of the report was that medical coders were more productive and accurate when they assigned ICD-10 codes from the provided documentation versus converting ICD-9 codes.

Lessons Learned from the Health Insurance Exchange Launch

John D. Halamka is one of the most thoughtful voices in the ICD-10 debate. We need to pay attention when he has warnings such as this:

"As I've written in my blog many times, ICD-10 will become a crisis for the Obama administration. Payers and providers will not be ready by October 1, 2014. Documentation systems and clinician billing process changes will not be mature enough to support a successful go live. More time is needed."

When reasonable voices say "more time is needed," while unreasonable voices are calling for blood after the rollout, something's going to give. (Life as a Healthcare CIO)

 Convention Q&A: How to get to ICD-10? Practice, practice

Rachel Chebeleu, corporate director of professional fee abstraction at the University of Pennsylvania Health System in Philadelphia, offers a preview of her presentation, “Coders Learn Coding by Coding – How to Prepare Coders for ICD-10” at next week's AHIMA conference:

"Practicing on an organization’s own records is probably the best. Also, practicing on the same records that your peers are practicing on is a good idea, so that ideas and issues can be discussed. Practicing on the records that potentially will be the most impacted by ICD-10 is also a good idea."

(Journal of AHIMA)

ICD-10-CM Implementation Deadline Less Than A Year Away

Preview of some of the presentations planned for AHIMA’s 85th Annual Convention and Exhibit:

  • “How to Prepare Your Documentation and Complete ICD-10 Education Before Time Runs Out”
  • “The Good, the Bad, the Reality:  365 Days until ICD-10 Adoption (Take Two)”
  • “How to Prepare Your Documentation and Complete ICD-10 Education Before Time Runs Out”

(Healthcare Technology Online)

Building the ICD-10 Bridge as You Walk on It: Tips for Success

  1. "Identify Your Physician Champions Now"
  2. "Collaborate to Share Services and Resources"
  3. "Look to Industry Associations for Support and Resources"
  4. "Leverage Everything You Can – People, Process, and Technology"
  5. "Identify Areas for Standardization, Centralization, and Increased Efficiency"
  6. "Communicate, Communicate, Communicate"
  7. "There Are No Shortcuts, Just Opportunities"
  8. "Think Outside the Box"

(Beacon Partners)

Readers Write: ICD-10: The Race is On and the Clock is Ticking

Honora Roberts, vice president of health provider services at Xerox, shares ICD-10 implementation tips:

  • Focus on the diagnoses you use the most.
  • Test your new systems and upgrades before Oct. 1.
  • Improve clinical documentation.
  • Give clinicians and medical coders proper training and practice.
  • Keep optimizing documentation and workflows.
  • Understand the risks and plan appropriately.
  • Lead from the top.


4 ICD-10 Staffing Strategies

  1. "Manage productivity expectations"
  2. "Provide schedule flexibility"
  3. "Stay competitive in the market"
  4. "Control resistance from older workers"

(HealthLeaders Media)

Why Y2K was no ICD-10

  • Y2K was a flip of the switch. The ICD-10 transition is an ongoing project.
  • The conversion was a purely technical project. Tech staff will only be responsible for 35 percent of the ICD-10 transition.

(Government Health IT)

ICD-10: Is Your Clinic Ready?

Pretty good advice on getting started on ICD-10 implementation. (WebPT)