AAOE ICD-10 Survey Questions Question Title 1. How many clinical staff members are in your practice (include doctors, nurses, mid-level providers and therapists): a. 1 to 10 b. 11 to 50 c. 51 to 100 d. 101 to 200 e. 201 or greater Question Title 2. Please select your practice setting: a. Private practice b. Academic Institution c. Hospital/Medical Center Question Title 3. Has your practice received information from any of the following vendors about their ICD -10 readiness or implementation? Yes No a. Your health plan/payers a. Your health plan/payers Yes a. Your health plan/payers No b. Your clearing house/billing vendors b. Your clearing house/billing vendors Yes b. Your clearing house/billing vendors No c. Your software vendors c. Your software vendors Yes c. Your software vendors No Question Title 4. Please describe your practice’s level of knowledge of ICD-10 implementation (Please select one response) a. Extremely knowledgeable (all relevant staff have received training and are preparing for ICD-10) b. Somewhat knowledgeable (some relevant staff have received training and are aware of ICD-10) c. Not very knowledgeable (relevant staff have not received training, but at aware of ICD-10) d. Not at all knowledgeable (relevant staff have not received training, and are not aware of ICD-10) e. Unsure Question Title 5. Does your practice have a Readiness Assessment plan for your technology, hardware/software and business processes? a. Yes, we have a plan and have begun the Assessment b. Yes, we have a plan but we have not begun the Assessment c. No, we do not have a Readiness Assessment plan d. Do not know Question Title 6. How complete are your IT systems update, design and/or development plans related to ICD-10 implementation? a. Unknown at this time b. Not yet started c. 1 to 25% complete d. 26 to 50% complete e. 51 to 75% complete f. 76 to 99% complete g. 100% complete h. Do not need Question Title 7. Does your practice have an implementation plan prepared for conversion to ICD-10? (Please select all that apply) a. Not yet started planning for ICD-10 b. Identified resources for ICD-10 c. Identified policy, procedure and/or business process revision needed related to ICD-10 d. Developed a training strategy for ID-10 implementation e. ICD-10 Training for all professional coding and billing staff is underway f. Identified that internal office record systems and billing software/vendors are ready g. Ready to use ICD-10 Question Title 8. If you have not begun ICD-10 implementation planning activities, please provide the reasons/obstacles (Please select all that apply) a. Other priorities/competing projects b. Lack of knowledgeable resources c. Not enough staffing resource d. Vendor readiness concerns e. Coordination with the trading partners/business associates f. Budget – lack of funding to support ICD-10 changes g. Significant IT impacts h. Significant business impacts i. Lack of executive leadership Question Title 9. If your practice does not have an implementation plan, when do you anticipate starting your ICD-10 planning? a. Q2 2013 (April – June 2013) b. Q3 2013 (July – September 2013 c. Q4 2013 (October – December 2013) d. Q1 2014 (January – March 2014) e. Q2 2014 (April – June 2014) f. Q3 2014 July – September 2014) g. Do not know Question Title 10. What, if any, of the following resources is your practice likely to use to learn more about ICD-10? (Please select all that apply) a. External web sites b. AAOS c. AAOE d. CMS web site e. Health plan or vendor web site f. Internal training g. Consulting services h. Do not intend to use any resources i. Do not know Done