Health Information Management

GAO weighs in on CMS' ICD-10 readiness

HIM-HIPAA Insider, February 16, 2015

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The Government Accountability Office (GAO) released a report January 28 analyzing CMS’ efforts to prepare for the transition to ICD-10. The GAO report is based on a review of CMS documentation, interviews with CMS officials, and information provided by 28 stakeholder organizations.

The GAO reported that CMS prepared for the transition in a variety of ways, including:
  • Developing educational materials for HIPAA covered entities (CE) and vendors
  • Conducted outreach to prepare CEs for the transition, including holding on-site training for some small physician practices
  • Organizing stakeholder meetings, focus groups, group testing, and surveys to monitor CE and vendor readiness
  • Changing Medicare fee-for-service (FFS) claims processing systems
  • Providing technical assistance for Medicaid agencies
Despite the actions CMS has taken to prepare for ICD-10, the stakeholders selected by the GAO identified the some concerns about the transition. Stakeholders said that CMS’ testing has not been comprehensive and that some CEs may not be aware of or using educational materials offered by CMS. CMS should offer additional on-site training opportunities and develop specialty-specific educational materials, according to the stakeholder recommendations. CMS should also make an effort to engage CEs through non-electronic methods and should publicize its Medicare FFS contingency plans.
In response, CMS confirmed that it is already on track with the majority of the recommendations set forth by stakeholders participating in the GAO report. CMS will conduct end-to-end testing April 26–May 1 and July 20–24. The agency stated it will continue to promote its educational materials to ensure CEs and others are aware of these resources. CMS also stated that it will offer additional on-site and video training and plans to develop specialty-specific educational materials. CMS noted that it engages CEs through stakeholder collaboration meetings, print advertising, and direct mail. In addition, contingency plan information relevant to providers is already publically available.


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