The Centers for Medicare & Medicaid Services (CMS) has established the ICD-10 compliance deadline for October 1, 2015.  This survey is intended to assess the overall readiness and status of our providers.

* 1. What is the name of  your healthcare organization?

* 2. What type of provider are you?

* 3. Do you plan to be ready for ICD-10 by October 1, 2015

* 4. What is the current status of your ICD-10 Program?

* 5. Who are you currently testing with or planning to testing with? (Check all that apply)

* 6. What is your organization's primary concern and/or obstacle regarding ICD-10?

* 7. Please provide your contact information below: (optional)

* 8. Please provide any additional comments, concerns, or suggestions below:

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