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CMS Implementation Planning

CMS has commissioned implementation reports and impact analyses for its internal use in preparing for transition to ICD-10 on October 1, 2015.

Key results are posted here to provide insights for other organizations as they plan.

CMS research, Industry Readiness Assessments and Listening Session

CMS is working closely with researchers and with industry groups representing providers, payers, and vendors to assess and support Version 5010 and ICD-10 progress.

Activities to gauge and assist with industry preparedness include:

ICD-10 Stakeholder Collaboration Meetings

ICD-10 stakeholder collaboration meetings with representatives from key industry groups held in Washington D.C. on:

Face to face and phone discussions

Held in early 2013, discussions found high awareness of the ICD-10 transition among providers, payers, and vendors. But readiness and awareness of the October 1, 2015, compliance date varied. Participants noted the importance of communication between vendors and providers, in particular. Some providers in small, independent practices say that they will prepare for ICD-10 when their vendors tell them to do so. Yet many have not heard from their vendors. CMS is working with vendors and providers to promote the dialog needed for a successful transition. 

Online Survey

A survey of approximately 600 providers, payers, and vendors (Survey results) showed widespread awareness of the version 5010 upgrade and ICD-10 transition among all three groups.  

Detailed Telephone Interviews 

Interviews were conducted with 27 small medical practices, payers, and vendors in February 2011. All three groups expressed confidence that they would meet the compliance deadlines, though many of those interviewed could not recall the deadlines. Both vendors and payers expressed concerns about provider readiness. Vendors were also concerned about payer preparedness.

Partner Readiness Assessments

Partner readiness assessments fielded by five organizations asked about preparation steps and expectations about meeting compliance deadlines. Key findings are presented in a summary of the detailed telephone interviews and partner readiness assessments results.

Environmental Scan

A February 2010 report on an environmental scan that looked at transition planning across key parts of the health care industry in 2009. The goal was to help identify potential issues early and resolve them through working with industry partners through outreach and education.

CMS ICD-10 Impact Analysis

In September 2008, CMS concluded a one-year project with the American Health Information Management Association (AHIMA) to identify and assess the business processes, systems, and operations under CMS' direct responsibility that would potentially be impacted by a transition to the ICD-10 code set. The analysis included information gathered from CMS components from late 2007 to early 2008 and was the first of several efforts that will be undertaken to prepare CMS for the transition to ICD-10.  AHIMA's executive report is available along with a more detailed report of AHIMA's initial findings

The second phase of planning was initiated in September 2008 by Noblis, and was built upon AHIMA's findings to include the impacts and risks surrounding new legislation and initiatives not accounted for in the AHIMA study as well as updated needed from the original analysis. 

This ICD-10 Impact Analysis further analyzes the impact of the transition from ICD-9 to ICD-10 on CMS policies, processes, and systems by confirming where CMS uses ICD codes, discussing the opportunities that ICD-10 presents to CMS, assessing the risks, and describing the high-level effort required to prepare CMS for the transition to ICD-10. Additionally, this document identifies strategies to reduce the consequences of potential negative events associated with the transition. This report also describes the high level activities required of each CMS component to prepare for ICD-10.