Outpatient Facility Coding Alert

Make use of Medicare’s hand holding end-to-end testing opportunity.

Are you aware of some testing opportunities available with your Medicare contractor before the actual “go live” date later this year? Don’t miss the opportunity to test things out before Oct. 1, 2015.

Take Advantage of the Final End-to-End Testing Option

If you want to know more than whether you can get CMS to accept your claims with ICD-10 codes, you might want to participate in end-to-end testing.

End-to-end testing processes claims through all Medicare system edits to produce and return an accurate Electronic Remittance Advice (ERA). While acknowledgement testing is open to all electronic submitters, end-to-end testing is limited to a smaller sample of submitters who volunteer and are selected for testing, according to an MLN Matters article.

Although the application deadline has passed for the next round of end-to-end testing, you will have one more opportunity. 

“If you weren’t selected to participate [earlier], we encourage you to reapply for the subsequent round of testing in July,” said Stacey Shagena with Medicare Contractor Management Group/CMS in a recent MLN Connects call.

CMS Satisfied With the Results of Test Claim Submission

Acknowledgement testing simply means that you submit claims with ICD-10 codes to the Medicare Fee-For-Service claims systems and receive acknowledgements to confirm that your claims were accepted or rejected.

“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,” stated CMS’s Suzie Chagniss during a recent CMS Open Door Forum on ICD-10 preparation.

The testing during those two 2014 dates did not identify any system issues with the Medicare system, “so we consider both of these tests to be a great success,” Chagniss added.

The first 2015 acknowledgement testing week was scheduled for March 2 to 6, but there is still the June 1 through June 5, 2015 testing period ahead. 

“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,” Chagniss said. “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.”

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. Look for opportunities to register for the July date on your MAC’s website.

Resource: You can read more about ICD-10 testing opportunities at www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1435.pdf. 

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