"The fiscal intermediaries for (Centers for Medicare and Medicaid Services), many of them are not even ready for 5010 and we have seen the impact on hospital cash because of delays and payers being unable to accept those federally mandated transaction standards," he says. "If we would have kept that ICD-10 implementation date in October it would have been considerably worse."
Stettheimer says payers also are having problems with the ICD-10 deadline.
"Our healthcare reimbursement environment is different from any other country. It is so convoluted," he says. "It is not tied to the diagnostic codes and if you change the codes you impact the whole reimbursement cycle within healthcare. It's not that the healthcare providers are standing alone and not being ready. It is the payers, all the insurance companies, the fiscal intermediaries that handle the transactions for CMS, all of these organizations, most of them aren't ready and would have a challenge getting ready."
ICD-10 implementation is further complicated, Stettheimer says, because there is no way to ease into it. "It is a little bit like a light switch. You go from ICD-9 to ICD-10 in a day," he says. "Because there is no way to not make it an instantaneous transition, the readiness and preparation and testing becomes that much more complex. We can't put just one hospital or unit up on ICD-10 and see how it goes."