In latest ICD-10 update, CMS plans limited end-to-end testing

April 30th, 2014 - Scott Kraft
Categories:   Diagnosis Coding  

A select few – a small sample group of providers that CMS says will represent a broad cross-section of provider types – will be selected to participate in end-to-end ICD-10-CM claims processing and payment testing this summer, CMS says in a recent update to its ICD-10 implementation plans.

The agency defines this end-to-end testing as the submission of test claims to CMS with ICD-10-CM codes and the generation of a remittance advice back to the provider with information about the adjudication of the claim.

CMS has not yet identified the exact dates when the testing will take place, but the announcement suggests the providers will be chosen by CMS, rather than being asked to volunteer. More information will be released closer to the summer.

It’s not clear how the impacts of the end-to-end testing will be scaled to other providers who are not participating.

There will still be what is called “acknowledgement testing” taking place from March 3-7, 2014, where all providers, billing companies and clearinghouses can submit claims with ICD-10 codes to determine whether or not they’ll be accepted. These test claims will not be adjudicated. CMS says it is looking at the possibility of doing other adjudication testing based on the results of the March 2014 test.

The agency still plans to implement the conversion to ICD-10-CM diagnosis coding on Oct. 1, 2014, though some provider groups still are agitating for a delay. It claims its own systems have been prepared to process ICD-10-CM codes since Oct. 1, 2013, the originally scheduled implementation date.


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