Pathology/Lab Coding Alert

Watch for July application.

If you think your lab is ready for ICD-10 implementation, you might want to test yourselves to be sure.

That’s why you should be aware of some testing opportunities available with your Medicare contractor before the actual “go live” date of Oct. 1 this year. 

Join In Acknowledgement Testing At Will

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 completed multiple, specific weeks devised to perform acknowledgement testing and provide customer support from MACs.

During one of the weeks, for instance, “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 weeks did not identify any system issues with the Medicare system, “so we consider … these tests to be a great success,” Chagniss added.

Future acknowledgement testing will occur June 1 through June 5. “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.”

Apply for 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.

You will have one more opportunity for the next round of end-to-end testing. “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.

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. 

Date announced: CMS recently publicized that the week of July 20 is the next opportunity for end-to-end testing participation. Each MAC will select participants, for a total of approximately 850 volunteer submitters. Review your MAC’s Website for the official announcement and instructions on submitting volunteer forms by the April 17 deadline.

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.