Medicare: ICD-10 Testing to Start This Week

The Centers for Medicare and Medicaid Services (CMS) has issued Medlearn Matters article SE1409 entitled: Medicare Fee-For-Service (FFS) International Classification of Diseases, 10th Edition (ICD-10) Testing Approach (revised Feb. 27, 2014). This article outlines steps providers can take to begin testing their claims submissions under the new ICD-10 format, with one phase of the testing occurring this week – March 3-7.

For dates of service on and after Oct. 1, 2014, entities covered under the Health Insurance Portability and Accountability Act (HIPAA) will be required to use the ICD-10 code sets in all standard transactions. This represents a major change in the formatting of electronic transactions and all impacted providers need to be preparing now for the transition.

As described in the article, CMS is taking a “four pronged” approach to the transition:

CMS internal testing of its claims processing systems;
Provider-initiated Beta testing tools;
Acknowledgement testing; and
End-to-end testing.

SE1409 describes these four stages of the transition testing and the current time frames in detail. The first scheduled week of the acknowledgement testing is this week, March 3 – 7, with CMS expecting to offer additional opportunities for this process over the coming months.

CMS is providing a variety of Beta testing tools as referenced in SE1409 and is also making available free software that providers may use if they are anticipating problems meeting the Oct. 1 deadline.

According to CMS:

“If you will not be able to complete the necessary systems changes to submit claims with ICD-10 codes by Oct. 1, 2014, you should investigate downloading the free billing software that CMS offers from their MACs. The software has been updated to support ICD-10 codes and requires an internet connection. Alternatively, many MACs offer provider internet portals, and some MACs offer a subset of these portals that you can register for to ensure that you have the flexibility to submit professional claims this way as a contingency.” (Source: Medlearn Matters SE1409)

For more information on ICD-10 and the Oct. 1 conversion, please refer to the Centers for Medicare and Medicaid Services ICD-10 resource page.

Please keep in mind that NY State Medicaid will be implementing its own testing process effective July 28, 2014. For NY Medicaid specific ICD-10 information, please refer to the eMedNY resource page.

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827