February 20, 2014
Area(s) of Interest: Payor Issues and Reimbursement Practice Management
The Centers for Medicare and Medicaid Services (CMS) announced yesterday that it will conduct end-to-end testing of ICD-10 billing code submissions with a limited number of providers this summer. Details of this test have not been released yet. According to CMS, a small sample group of providers will be selected for testing to represent a broad cross-section of provider types, claims types and submitter types.
CMS had previously said it wouldn't do such testing for the bill-coding system which goes live Oct. 1. However, pressure brought by physician groups, spearheaded by the American Medical Association (AMA), seems to have caused the federal agency to reconsider its plans to conduct more in-depth testing.
After the CMS announcement, the AMA released a statement congratulating the agency on its decision to go ahead with the more rigorous testing. “AMA believes end-to-end testing is essential for ensuring the health care industry will not suffer massive disruptions in claims and payment processing and ultimately risk physicians’ ability to care for their patients,” said AMA President Ardis Dee Hoven, M.D.
An AMA study released last week showed the mandated implementation of the ICD-10 code set will be dramatically more expensive for most physician practices than previously estimated. “While the AMA is pleased by the federal government’s decision today to conduct end-to-end ICD-10 testing, the AMA continues to urge CMS to reconsider the ICD-10 mandate during a time when physicians are struggling to keep up with many other costly, federal mandates,” said Dr. Hoven.
The end-to-end testing is in addition to the front-end testing already scheduled to take place the week of March 3, 2014. The front-end testing week will give trading partners access to the Medicare Administrative Contractors (MACs) and Common Electronic Data Interchange (CEDI) for testing with real-time help desk support. These tests will look at how well the system works from the provider's side – that is, how easily and accurately providers can submit claims – using the new codes. (Registration is required for the March ICD-10 testing. To register, visit the Noridian website.)
End-to-end testing dates have not yet been set.
ICD-10 is scheduled to go live on Oct. 1, 2014, despite complaints from many in the provider community that they aren't ready. A Medical Group Management Association survey released in January found fewer than only one in 10 physician practices (9.4 percent) believe they've made "significant progress" in preparing for the upcoming ICD-10 transition.
Billing experts advise physicians to start preparing for the ICD-10 transition now if they haven’t yet done so. Steps to take include upgrading software systems, testing those updated systems, training staff and updating payer contracts and fee schedules. AMA offers free educational resources that can help physicians get started.