General Surgery Coding Alert

Look ahead to more testing opportunities.

Following the ICD-10 implementation delay announcement earlier this year, CMS’s silence about ICD-10 testing had been deafening.

But now, at last, CMS has announced that Oct. 1, 2015 is the official implementation date. Plus, you can get some insights for your general surgery practice with CMS’s recent comments about ICD-10 testing.

March Test Successful

During a meeting of the Standards Subcommittee of the National Committee on Vital and Health Statistics (NCVHS) last month, CMS’s John Evangelist said that the March 3-7 ICD-10 testing was quite successful, with 127,000 ICD-10 claims finding their way through the fee-for-service claims system. 

The national average for claims success was 89 percent, although some regions successfully processed 99 percent of the claims submitted. Among the 2,600 entities that submitted ICD-10 claims during testing, more than 50 percent were clearinghouses, and the rest were physician practices, hospitals, labs, ASCs, dialysis facilities, billers, home health providers and ambulance services.

End-to End Testing Proceeds

Regarding end-to end testing that was originally scheduled for July, the agency’s Denesecia Green denied that end-to-end testing was permanently cancelled—instead referring to the testing as simply being delayed. “There will be testing,” Green said to the group.

Background: The March test simply allowed entities such as physician practices to submit ICD-10 claims to MACs to ensure that the claims are accepted. But the end-to-end testing will be more in-depth than the March tests, because the end-to-end testing will allow practices to ensure not only that claims are accepted, but also that they are adjudicated properly.

End-to-end plan: When the agency announced the end-to-end testing originally scheduled for July, CMS’s Larry Young stated, “This is testing where providers will submit ICD-10 code claims to their MACs and will receive a remittance advice and adjudication—we call it submit to remit.” Young continued, “We’ll have a statistically significant sample of providers including physicians, hospitals, clearing houses, billing agents, and they’ll be available to test at all 16 MACs across the country.” 

Await instructions: With the delay firm but the plan fuzzy, you’ll need to keep a lookout for further CMS announcements about end-to-end testing. Keep your eye on the pages of General Surgery Coding Alert to make sure you don’t miss out on this ICD-10 prep opportunity.