HHS’ ICD-10 Code Deadline Arrives

With the arrival of October 2015 come changes beyond the color of the leaves, as it signifies the U.S. Department of Health and Human Services’ (HHS) deadline for hospitals, physician practices, other healthcare providers and payers to have completed the transition from ICD-9 to ICD-10 (International Classification of Diseases, Revision 10) coding systems.  ICD-10 provides more granular coding during a patient’s medical treatment, generating specific data that is expected to improve healthcare delivery.  Benefits of the more advanced coding include the ability to:

  • Develop a more detailed patient history
  • Better coordinate patient care across providers and over time
  • Improve quality measurement and reporting
  • Detect and prevent fraud, waste, and abuse
  • Gain more accurate metrics for Federal or private insurance reimbursement

Additionally, since ICD-10 coding includes more complete information on the medical conditions that providers treat, the level of data capture and analytics is expected to allow for more advanced surveillance of public health and quality reporting on a national scope.

For all of these benefits of implementing a more complete medical coding system, it has been a process fraught with difficulties…particularly for healthcare providers and insurers.  They have had to shoulder most of the financial responsibility for the operational upgrades necessary to be able to track, code, store and share the data-heavy ICD-10 coding system that is required to participate in reimbursement programs.

Porter Research – a Billian Company – has been working with many healthcare organizations over the past few years leading up to the ICD-10 deadline to develop research programs that would provide key metrics of what was taking place in the healthcare marketplace, as providers scrambled to fund and implement these changes within their business model to achieve regulatory compliance.

“I recently attended the AHIMA [American Health Information Management Association]trade show, and there was a lot of optimism going around about the kickoff for ICD-10, and how well things were going,” said Cynthia Porter, president of Porter Research.  “But there’s also the lingering question about what happens if claims don’t get paid in 30 days-time.  I think there is an undercurrent of nervousness about the potential for claims to be denied for some unexpected reason.  In the end, only paid claims will start alleviating the concerns held by healthcare providers and payers.  Training and workflow challenges associated with the ICD-10 transition will continue well past October.”

Navicure, a provider of cloud-based healthcare billing and payment solutions, commissioned Porter Research to conduct a recent national survey of healthcare organizations to gauge their preparedness for the ICD-10 transition.  The August 2015 Healthcare Organization ICD-10 Readiness Survey revealed a mixture of confidence along with apprehension from survey participants, the majority (58%) of whom serve as physician practice administrators or billing managers.  Some key survey findings include:

  • 85% of respondents stated that they are optimistic about ICD-10 preparedness
  • 94% of respondents anticipate an increase in their claims denial rate
  • Over 50% of respondents anticipate a negative impact on their organization’s finances, operations and staff morale as a result of the transition to ICD-10.

“The ICD-10 Readiness Survey that Porter Research conducted helped Navicure understand what was important and needed in the marketplace to meet the HHS deadline.  This insight from key healthcare industry stakeholders allows Navicure to better understand the market realities of what is actually taking place during the transition,” stated Phil Dolan, Navicure’s Chief Marketing Officer.  “Thankfully, it appears that the ICD-10 deadline arrival has been uneventful so far, as we enter into October.  I think this level of preparedness indicates how hard providers and vendors have worked together over the past few years in order to reach this point.”  To view the complete survey key findings and action items, visit survey results

Navicure has been working with healthcare providers to assist them through the ICD-10 transition process, to ensure that their day-to-day business operations avoid unnecessary disruption.  The IT solution company even offers free access to ICD-10 transition tools that include online correction of rejected claims, expanded claim tracking, and ICD-9 to -10 mapping for any payers that turn out to be unprepared for the change.  Navicure’s ICD-10 resource webpage is available at click here

The Centers for Medicare & Medicaid Services (CMS) announced earlier this year that non-compliant ICD-10 Medicare claims would be accepted during the 12-month period past the deadline date.  However, this does not extend to Medicaid, BCBS and commercial plans. Additionally, the CMS is working with the American Medical Association (AMA) on a series of proactive initiatives [ For more details, click initiative ] to help physicians and other healthcare providers that are struggling to achieve regulatory compliance.  The two agencies – representing governance and the medical community – realize the need for addressing the individual challenges faced by healthcare providers beyond an inflexible deadline date as the healthcare industry modernizes its coding system nationwide.

Survey Gauges Medical Practices’ Attitudes toward ICD-10

NueMD recently released findings from their April 2015 survey exploring small and mid-sized medical practices’ attitudes towards the pending transition to ICD-10, a more granular disease and diagnosis classification system.

With the October implementation deadline fast approaching, NueMD surveyed 1,000 medical practice professionals and billers about their stress levels, areas of concern, the general sense of preparedness regarding switching to the new coding standards.

When asked how confident they are that their employees will be trained by the ICD-10 deadline, only 11.4% of survey respondents indicated feeling “highly confident,” with the most common response being “Not at all confident” (35%).


View NueMD’s ICD-10 survey findings report to learn more about survey participants’ attitudes, concerns, expectations and preparedness related to ICD-10 adoption.

About NueMD
NueMD is the leading provider of cloud-based medical practice management software for small practices. Powered by Nuesoft Technologies, Inc., NueMD offers practice management, electronic health record and medical billing software and services to help physicians maintain the clinical and financial well-being of their practice. For more information please visit

Navicure Survey Reveals ICD-10 Optimism despite Minimal Preparation

Navicure, a provider of cloud-based healthcare billing and payment solutions, today announced key findings from its third ICD-10 readiness survey, deployed in January 2015 in conjunction with Porter Research. The findings revealed physician practices are generally optimistic about being ready for the October 1, 2015, transition date, although only 21 percent feel they are currently on track with preparation efforts.

As with Navicure’s first two surveys, the majority of participants (57 percent) were practice administrators or billing managers from practices with one to 10 providers. The next largest group was billers and coders who made up 14 percent, followed by practice executives (13 percent).

The survey found physician practices’ state of ICD-10 preparedness varies widely. The majority (81 percent) are still optimistic they will be ready when the transition happens, and overall optimism toward ICD-10 readiness generally remained high. The findings were centralized around the themes of timing, readiness and challenges, including:

  • Physician practices don’t think ICD-10 will be delayed again. The majority of respondents (67 percent) believe the ICD-10 transition will take place on the October 1, 2015, implementation deadline.
  • Potential impact on revenue and cash flow is the greatest concern. Fifty-nine percent of respondents noted cash flow was a concern, while 12 percent indicated their greatest concern is staff productivity, followed by 11 percent who are most concerned the transition will be delayed again.
  • Respondents feel the biggest challenge will be dealing with unprepared payers. Forty-one percent of respondents cite lack of payer readiness as the most challenging aspect of the transition. End-to-end testing with payers remains a priority for practices, though the percent of those opting out of testing opportunities is increasing.

“Since 2013, Navicure has been conducting ICD-10 readiness surveys, which have allowed us to gain broad perspective on how we can best help healthcare organizations prepare for the transition,” said Jim Denny, founder and CEO of Navicure. “We remain committed to providing ICD-10 education and training resources for both clients and prospective clients, and we are eager to help them through a successful transition so they can maintain healthy revenue cycles and efficient workflows.”

This survey was a follow up to surveys conducted in April and November 2013. Navicure will sponsor additional surveys in 2015 to continue monitoring changes in attitudes and transition activities as the implementation deadline draws near. To view the complete, current survey results and analysis, visit

About Navicure
Navicure’s cloud-based healthcare billing and payment solutions help healthcare organizations of all sizes increase revenue, accelerate cash flow, and reduce the cost of managing insurance claims and patient payments. Serving more than 50,000 healthcare providers nationwide, Navicure’s technology solutions automate account receivables processes, including claims management; patient eligibility verification; remittance and denial management, including automated secondary claims filing, appeals, and posting; reporting and analysis; and patient payment collections at and near the time of service. Navicure’s solutions are supported by its unique 3-Ring® Client Service which guarantees that a client service representative will answer every client call in three rings or less, even during times of transition such as 5010 and ICD-10.

Navicure is the exclusive billing and payment solution of the MGMA AdminiServe® Partner Network and an MGMA Executive Partner. In the past seven years, Navicure has been included among the top three clearinghouses in a field of more than a dozen solutions ranked by KLAS® (, winning “Best in KLAS” distinctions in 2008, 2010 and 2012. Navicure also received the 2013 Gold Stevie Award for Healthcare Customer Service Team of the Year as part of the 2013 Stevie Awards for Sales and Customer Service. Navicure continues to be ranked among the fastest growing companies nationally in the Inc. 5000 and Deloitte Fast 500 rankings. For more information, please visit

About Porter Research
Porter Research – a Billian Inc. company – has for over 20 years worked diligently to understand and assess each client’s unique needs and to build a customized business-to business research program to achieve desired goals.

The company has worked with over 300 healthcare IT companies, providing many with Goto-Market Strategies based on its unparalleled experience, proven methodologies and knowledge-based analysis. Porter Research enables its clients to operate in a fast-changing market of new, emerging technologies and health reform issues such as ICD-10. It provides the unbiased results that healthcare clients need to make informed, strategic business decisions.

For more information, visit, follow @PorterResearch on Twitter, or call 678-282-1033.