To address concerns about the upcoming transition to ICD-10, the Centers for Medicare and Medicaid Services announced Feb. 20 that it would conduct full end-to-end testing this summer.
End-to-end testing will allow selected physicians, health care providers, hospitals, clearing houses, and billing agents to submit claims with ICD-10 codes, have those claims processed, and receive accurate remittance advice regarding payment.
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End-to-end testing will allow selected physicians, health care providers, hospitals, clearing houses, and billing agents to submit claims with ICD-10 codes, have those claims processed, and receive accurate remittance advice regarding payment.
The test will be conducted by a statistically significant sample of providers gleaned from a pool of volunteers, CMS officials said during a webinar on ICD-10.
Providers can apply to participate through one of the 16 Medicare Administrative Contractors (MACs) in March; the agency will announce those selected sometime in April. More details will be available on the CMS ICD-10 website in a few weeks, CMS officials said.
Physician groups have sought such thorough testing and heralded the CMS announcement.
"The 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 Dr. Ardis Dee Hoven, president of the American Medical Association, in a statement. "The AMA urges CMS to conduct the testing as soon as possible and to ensure that there is an adequate sample which includes a variety of different-sized medical practices and specialties."
The Medical Group Management Association also supports end-to-end testing, according to Dr. Susan Turney, president and CEO. However, the MGMA would like to see the CMS expand the scope of the testing "to include any provider who wishes to test with them," Dr. Turney said in a statement. That would minimize the possibility of "potential operational problems similar to what was experienced with the rollout of healthcare.gov," and "help to decrease the potential of catastrophic cash flow disruption that could impact the ability of practices to treat patients."
The AMA said that it continues to seek a delay in the Oct. 1 implementation of the new coding set, but CMS officials said that would not happen.
"I want to make really clear that the Oct. 1, 2014, date is firm," said Robert Tagalicod, director of the Office of eHealth Standards and Services at the CMS. "If you are a medical practice and haven’t talked with your vendors, clearing houses, and payers, now is the time to act."
CMS officials also noted that acknowledgment testing for interested providers starts soon. The first official period will be March 3-7. The test will let physicians determine whether their ICD-10 coded claims would be accepted or rejected. The claims will not be adjudicated. Doctors can apply through their MAC website for the testing; so far, some 2,500 have signed up for the March dates.
The agency will offer more official test periods, and will provide information on those soon, officials said. Physicians also can request unofficial testing with their MAC any time between March and October. The results of those tests won’t be included as part of the CMS’s official statistics.
Denesecia Green, of the CMS Office of eHealth Standards and Services, said that the agency wanted to reach out more to small physician practices. The agency is collaborating with state medical societies and national physician organizations to do so.
She also said that the CMS offers specific training for physician offices, and free billing software. More information about those programs can be found on the ICD-10 website.
Both the AMA and the MGMA also provide tools to help physicians make the transition.
But, Dr. Hoven said, although adopting the new code set "may provide benefits to others in the health care system, [it] is unlikely to improve the care physicians provide their patients and takes valuable resources away from implementing delivery reforms and health information technology."
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