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Expect no delay to new diagnosis coding system.

CMS held an ICD-10 testing period this month, but the agency has an even more in-depth system up its sleeve that will ensure claims will process appropriately once the new diagnosis coding system goes into effect.

“End-to-end testing” was just one of the many ICD-10 topics that the Centers for Medicare & Medicaid Services discussed during its Feb. 20 ICD-10 Readiness Webinar.

No Change In Date

First and foremost, CMS reps reiterated yet again that there won’t be a delay in the ICD-10 compliance date, which many callers to the forum questioned. “The ICD-10 date is firm,” said CMS’s Robert Tagalicod during the presentation.

“CMS has been working very closely with numerous stakeholders ... to ensure a smooth transition to ICD-10,” Tagalicod said. “We recently launched the ICD-10 success initiative as part of a collaboration to share guidance and insights.”

CMS has performed its own tests to ensure that the software systems are ready to process ICD-10 claims. “To date, CMS has completed over 60,000 hours of analysis, programming, and testing related to ICD-10,” said CMS’s John Evangelist in the call. In addition, independent contractors have begun to implement edits to ensure claims process correctly, he added.

CMS offered a week for the provider community to perform ICD-10 testing with the MACs, said CMS’s Stacey Shagena during the call. From March 3 through March 7, providers submitted ICD-10 claims to MACs. More than 2,500 submitters had already registered for the testing at the time of the call, Shagena added. MACs will also announce additional testing weeks in the future. 

In addition, many MACs have agreed to allow providers to perform private testing sessions outside of the formal ICD-10 testing weeks. This will be up to the MACs’ discretion, but if you’d like to participate in a private testing period, contact your MAC directly, she said.

You won’t have to wait until the testing period is over before you get an acceptance or rejection on your claim. “You would get a rejection in a similar timeframe that you’d get a rejection in a production environment,” Shagena said.

However, you will not be able to report both ICD-9 and ICD-10 codes on the same claim during the testing period, because these sample claims should look exactly like the actual ICD-10 claims you’ll be submitting as of Oct. 1.

The test claims won’t be subject to date of service edits, either. Although ICD-10 codes won’t be accepted until Oct. 1, you don’t need to put an Oct. 2 date on your test claims. Instead, you can submit your claims with current dates of service, Shagena added.

Register For Testing By March 24

Missed the ICD-10 testing this month? You may get another chance in a formal CMS program.

CMS has announced its end-to-end ICD-10 testing period in July. MACs will choose a sample of 32 participants each “to represent a broad cross-section of provider types, claims types, and submitter types,” the contractors say in messages to providers. “Selected testers will be notified that they have been selected by April 14, 2014. Those selected will be provided specific details regarding how to test and who to contact for testing support.”

The July testing will differ from the March tests, said CMS’s Larry Young during  the webinar. “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,” he said. 

“The testing will be using fiscal year 2014 pricing files, so there will be a full submit to remit, with an adjudication and remittance advice, but you wouldn’t be receiving the fiscal 2015 pricing amounts since they won’t be available,” Young added.

This testing will be more in-depth than the test claims processed during the March 3 testing week, because the end-to-end testing will allow providers to ensure not only that claims are accepted, but also that they are adjudicated properly. v

Note: More information about the July end-to-end testing is at www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8602.pdf and the volunteer form is at www.surveymonkey.com/s/ PM3FLG5.