Surveys say: How health orgs plan to comply with HIPAA 5010, ICD-10

Carl Natale
by Carl Natale

More than one road leads to HIPAA 5010 or ICD-10. Healthcare organizations can upgrade relevant applications, for instance, remediate existing systems, roll the HIPAA 5010 and ICD-10 work into  an EHR implementation, or hope for the best and rely on clearinghouses. And then there's always the combination of one or more of those avenues.

Offering evidence of the role new and upgraded applications will play in the conversions, analyst house Gartner, in a MarketScope (client registration required) focusing on the challenges in healthcare core administrative systems, said that market “is on the verge of unprecedented growth due to new business demands, master applications for consolidation and modernization efforts, and the need for ICD-10 compliance solutions. A preponderance of the U.S. health insurance core administrative applications will be replaced, upgraded or remediated between 2010 and 2013,” the report states.

More specifically, HIMSS' latest HIPAA 5010 and ICD-10 readiness survey determined that, among providers, 56 percent of respondents intend to comply by upgrading or replacing their practice management or patient accounting system, while 9 percent will make the HIPAA 5010, ICD-10 transition as they institute an EHR, and 12 percent will rely on clearinghouses.

[Related: What to do if your vendors are late with HIPAA 5010, ICD-10 updates. Podcast: Proper timing for ICD-10 training.]

HIMSS study also found that 23 percent of provider respondents have yet to determine which approach they'll take, a statistic very similar to our own admittedly smaller ICD10Watch reader poll, which found that 25 percent of voters “don't yet know” how, exactly, they'll get to HIPAA 5010 and ICD-10 compliance.

One key difference in our findings is that 50 percent of voters indicated they hope to rely on clearinghouses, while 25 percent will upgrade applications, and not a single voter mentioned pulling HIPAA 5010 or ICD-10 under the EHR umbrella.

Regardless of which on-ramp providers and payers choose to reach compliance, timing is critical. As Computer Sciences Corp. stated in a report, discussed in the article 3 Key ICD-10 questions providers should answer right now, “the fact remains that  organizations that have not begun their ICD-10 remediation efforts are at risk of missing the current deadlines. What's equally clear is that the deadlines are unlikely to be adjusted again.”