ICD-10 Provider Readiness Survey
Results, November 2012
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contents
• purpose
• demographic of respondents
• demographic of specialty type
• key findings & recommendations
• next steps
• survey highlights by provider type
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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:
1. Providers reliance on practice management systems to
select ICD-10 codes.
2. Providers’ concern regarding ICD-9 to ICD-10 translation or
mapping, versus their ability to send a compliant claim
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survey response demographics:
provider type
Provider Type Response Total vs Invitation
100%
90%
80%
70%
60%
Invitations
50%
Responses
40%
30%
20%
10%
24%
23%
12%
0%
HMO IPA/MG_CFO
PPO_Indv & MG
Facility_CFO
*Fax & postal mail outreach results were excluded, due to a .5% response
rate.
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survey response demographics:
specialty type
%of Response rate by Specialty
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
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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 ICD10 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 ICD10 Procedure Coding System is new, training and review of all
associated medical policies is also strongly recommended.
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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.
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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
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Appendix- Survey highlights by
provider type
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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 ICD10, rank order:
1. Understanding code use in billing- 45%
2. Costs related to implementation- 20%
3. System programming implementation in time for
compliance-15%
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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:
1. Understanding code use in billing- 48%
2. Costs related to implementation- 24%
3. System programming implementation in time
for compliance-16%
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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:
1. Understanding code use in billing- 45%
2. Costs related to implementation- 15%
3. System programming implementation in time for
compliance-11%
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