Pay and Practice: CMS to Test ICD-10

Beauty at a meeting

Beauty at a meetingMark your calendars — the Centers for Medicare and Medicaid Services (CMS) announced it will conduct front-end testing of ICD-10 billing code submission between Medicare Administrative Contractors (MACs) and providers.

That means CMS will be testing how well the system works from the provider’s side — that is, how easily and accurately providers can submit claims — using the new ICD-10 billing codes once they take effect in October.

The catch? It will only be done between March 3 and 7.

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The coding system — the name is short for International Classification of Diseases, version 10 — greatly expands the number and specificity of codes providers use to bill insurance companies.

“The ICD-10 testing week has been created to generate awareness and interest and to instill confidence in the provider community that CMS and the MACs are ready and prepared for the ICD-10 implementation,” read an announcement recently published by CMS. “This testing week will give trading partners access to the MACs and CEDI [Common Electronic Data Interchange] for testing with real-time help desk support.”

According to CMS:

  • Each MAC will host a registration site for the testing week, or provide an email address for the trading partners to provide registration information.
  • During the testing week, help desk support will be available, at a minimum, from 9:00 a.m. to 4:00 p.m. local contractor time, with enough support to handle any increased call volume.
  • Providers and suppliers participating during the testing week will receive electronic acknowledgement confirming that the submitted test claims were accepted or rejected.

Provider groups such as the Medical Group Management Association have called on CMS to conduct full testing — from the functionality of the claims database to physician office interfacefor ICD-10 codes, especially in light of the recent blunders with the Healthcare.gov rollout.

Physicians are worried that the more granular detail needed with ICD-10 codes will create a huge burden for practices. Furthermore, insurers aren’t expected to process unspecified codes, which are commonly used by doctors who may not know how to exactly diagnose a patient when they see them.

The American Academy of Family Physicians offers a “frequently asked questions” about ICD-10. The American College of Physicians provides ICD-10 training.

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Originally published on: MedPage Today

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This Post Has One Comment

  1. Tamra Harmon

    Do I need to buy a new bundle code set for the ICD-10 coming up? Or is there code sets books that just show what is revised? this is getting expensive for me I have an certification exam in March coming up.

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