Orthopedic Coding Alert

Each MAC will choose 50 participants per session.

If you were overlooked for the current round of ICD-10 end-to-end testing, take heart—CMS will be offering the testing again in both April and July. If you already applied for the January session, CMS will automatically re-register you for the subsequent rounds, but if you didn’t put your name in for the January testing, you can apply with your MAC for the future periods.

CMS reps discussed this, as well as several other issues, both as part of a Jan. 7 Open Door Forum call as well as in a recently-updated MLN Matters article SE1435, which covers many FAQs about the ICD-10 coding system.

CMS: “We’re Ready”

“CMS has taken a comprehensive four-pronged approach to prepare and test ICD-10 to ensure that CMS, as well as the Medicare Fee-for-Service provider community, is ready for this large transition,” said CMS’s Suzie Chagniss during the Jan. 7 call. “Internal processing of claims transmissions involves the first part of the plan, and acknowledgement testing and end-to-end testing encompass the next two phases,” she said.

“CMS has already accomplished the completion of our internal system testing of as October, 2013,” Chagniss added. “Since that time, only minor system changes were needed to revise the implementation date due to the delay to this October. MACs have verified their internal systems and have updated and tested, and they are ready for implementation. CMS has now completed two acknowledgement testing weeks with submitters in March and November 2014. During the March acknowledgement testing week, testers submitted over 127,000 claims with ICD-10 codes and received acknowledgements confirming that claims were accepted.”

With about five percent of the submitting community participating in the testing during March, CMS found that the tests did not identify any issues with the agency’s system. “We repeated this type of testing again in November,” she said. “The testers submitted over 13,000 claims for this testing…testing again did not identify any system issues with the Medicare system, so we consider both of these tests to be a great success,” Chagniss added.

Future acknowledgement testing weeks are scheduled for March 2 to 6, as well as June 1 through June 5 of 2015. “In addition to this, providers are invited to submit acknowledgement testing claims at any time up until the deadline of Oct. 1 of this year,” she added. “The advantage to testing during the testing week allows for additional customer service support from the MAC and during this time CMS collects data so we can report out our national statistics.”

Look for End-to-End Testing Options

In addition to acknowledgement testing, CMS’s upcoming end-to-end testing will offer the provider community an opportunity to submit claims during January, April and July.

“Approximately 850 providers will have the opportunity to participate during each of the testing periods for a total of 2,550 individual testers,” Chagniss said. “The goals of this testing are to demonstrate the providers and submitters are able to submit test claims successfully, that those claims will be adjudicated properly, and that accurate remittance advices are provided.”

Each MAC will select 50 participants per testing round. To be eligible to test, you must be ready for ICD-10, including ensuring that your vendor software is ready to use. In addition, you must be a direct submitter to Medicare and be able to receive electronic remittance advice. MACs have already selected participants for the Jan. 26 to 30 period, and CMS will publicly release the in-depth results of the first round by the end of February. Registration for the April testing is now open. The deadline to volunteer has been extended to Jan. 21. You can register on your MAC’s website.

To read the MLN Matters article on this topic, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1435.pdf.