ICD-10 pilot project finds testing crucial

According to the results of the HIMSS/WEDI ICD-10 National Pilot Program, any entity touched by the approaching deadline for the new coding system should take testing very seriously.

"ICD-10-CM/PCS touches almost every aspect of the healthcare continuum," the authors concluded. "All affected entities should be implementing and testing at this point in time. Create a strategy if planning has not begun. Build a solid structure surrounding internal and external testing, engage trading partners early, identify technical and business needs, and engage the business in developing 'day in the life' scenarios."

Average accuracy of the coders involved in the program was 63 percent, with some instances of 100 percent accuracy (e.g., "single live born,  born in the hospital, delivered by Caesarean section"); others (e.g., "pain of the limb") received a 33 percent accuracy score because specificity and laterality were not included.

Among the recommendations the report makes for healthcare organizations implementing ICD-10 testing programs are:

• Find a testing solution that is reusable and repeatable; avoid one-time-only solutions;
• Move away from silo-based testing software and approaches that inhibit collaboration across the healthcare continuum because as an industry unfunded mandates require high-level cost containment strategies;
• Assign all codes from a native ICD-10 perspective rather than converting from ICD-9 to ICD-10;
• Anticipate coding discrepancies; participate in a group that allows for a national discussion regarding discrepancies; and
• Engage in transparency across the organization.

"Now that the ICD-10 National Pilot Program has concluded as of August 30, 2013, the next step for the healthcare industry is to consider participating in the National Testing Program (NTP) for ICD-10," authors said. "NTP is a collaborative, transparent, asynchronous testing methodology using actual (not simulated) medical records, proxy testing and a work-social business process that leverages lessons learned and best practices from participating organizations. The NTP launched on August 1, 2013 and focuses on providing solutions for industry external testing."