March 3–7 marked the official testing week for this year’s Oct. 1 go-live date for the International Classification of Diseases, 10th Revision (ICD-10). Getting the testing week on the calendar was a big win for the ACR and other professional organizations that had been lobbying for a test run before mandatory implementation of the significantly revised codes.
“There was an outcry from the ACR for ICD-10 testing to make sure physicians, hospitals and everyone in the healthcare world will be able to have a smooth workflow once Oct. 1 is here,” says Antanya A. Chung, CPC, CPC-I, CRHC, CCP, director of practice management at the ACR. “We want to make sure the transition is smooth … [and that physicians] will be able to send their claims through easily.”
The testing week was important for rheumatologists in private practice in particular, Chung says. Properly switching over to the ICD-10 codes will affect payment and claims processing.
For testing, providers and suppliers submitted test claims to Medicare administrative contractors (MACs) using ICD-10 codes through the Common Edits and Enhancements Module (CEM) and Common Electronic Data Interchange (CEDI). Providers were expected to receive electronic acknowledgment that their test claims were accepted or rejected, although CMS did not require MACs to confirm claim payment or provide remittance advice.
“The ICD-10 testing week has been created to generate awareness and interest, and to instill confidence in the provider community that CMS and the MACs are ready and prepared for the ICD-10 implementation,” CMS noted in its transmittal document. “This testing week will allow trading partners access to MACs and CEDI for testing with real-time help desk support.”
Results of the testing week are expected to be in to CMS on or before March 18. CMS instructed contractors to report:
- The number of trading partners conducting testing during the week
- The percentage of trading partners who conducted testing compared to the number of trading partners supported by contract
- The percentage of test claims accepted and rejected
- Any significant issues
Another round of testing is now expected to take place this summer and will go end to end, processing claims completely, Chung says. Although CMS notes only that the summer testing will involve “a select group of physicians,” Chung anticipates “there will be a lot of stipulations and requirements for physicians to participate. End-to-end testing should be all-inclusive so CMS and providers will have a better understanding of how this will impact the entire healthcare system.”
(Posted March 13, 2014)
Kimberly J. Retzlaff is a medical journalist based in Denver.
