Health Information Management

Final chance to volunteer for ICD-10 end-to-end testing

APCs Insider, March 21, 2014

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Providers have until Monday, March 24, to sign up for CMS' ICD-10 end-to-end testing that will occur in late July. Simply volunteering won't guarantee the opportunity to participate, however, as MACs will be randomly selecting providers.

In MLN Matters article MM8602, CMS details how it expects to conduct the testing and what steps providers need to take to participate. After filling out the volunteer forms on their MAC websites, providers will be notified by April 14 if they have been selected. Providers who submit through a clearinghouse will only be eligible to participate if their clearinghouse is chosen. Each MAC will pick 32 submitters, which are supposed to be random, yet still supply a mix of provider types. Roughly 500 total participants will take part.  

The volunteers will then receive more information from the MACs, including what dates of service to use and what test indicators should be set. Each volunteer will be limited to 50 claims for the entire testing week, submitted in no more than three files.  

The end-to-end testing, which will take place July 21-25, is expected to demonstrate that:

  • Providers or submitters are able to successfully submit claims containing ICD-10 codes to the Medicare FFS claims systems
  • CMS software changes made to support ICD-10 result in appropriately adjudicated claims (based on the pricing data used for testing purposes)
  • Accurate Remittance Advice is produced

CMS has also provided detailed checklists that show what the step-by-step process will look like for providers of all sizes, as well as vendors and payers.

CMS' reversal on conducting end-to-end testing shows that it is working to ease provider concerns about ICD-10 implementation, but if problems develop during the testing week, will providers even have a chance to correct them? By the time CMS releases any results of the testing, providers will have less than 60 days to institute changes. There's also the concern of volume, which the government only realized belatedly with the launch of Healthcare.gov. Whether 50 claims over the week from 500 volunteers will truly test the system and expose any potential problems won't be known until actual claims submissions begin October 1.

 



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