CMS confirms dates, figures for ICD-10 testing

End-to-end ICD-10 testing for providers, announced late last month by the Centers for Medicare & Medicaid Services, will take place this July, CMS confirmed on Friday.

The agency announced that providers wishing to participate in the testing who submit claims to Medicare Claims Administration Contractors, A/B MACs and/or Home Health and Hospices MACs must complete a volunteer form on the MAC website by March 24. Test claims will be submitted between from July 21-25.

Each MAC, according to CMS, will select 32 submitters to participate in the testing; submitters will comprise of a "mix of provider types;" more than 500 providers, overall, will participate. Testers will be from clearinghouses and picked at random.

The agency "will allow for a small subset of Medicare claims submitters to test with MACs and the Common Electronic Data Interchange contractor to demonstrate that CMS systems are ready for the ICD-10 implementation," the announcement says. "This additional testing effort will further ensure a successful transition to ICD-10."

Providers selected for testing will be notified by April 14, and are limited to submitting a maximum of 50 claims, in no more than three files. CMS warns that if more than 50 claims are submitted by a single provider, that provider runs the risk that those claims may not be processed.

MACs will inform those selected what dates of service may be used for testing.

The testing comes in the wake of criticism by the American Medical Association, which published a report in February concluding that ICD-10 implementation costs will be more expensive than previous estimates for physician practices. Several groups--including the Medical Group Management Association, the American Hospital Association and the Workgroup for Electronic Data Interchange--previously had called for CMS to consider end-to-end testing in preparation for the switch.

New research in the Journal of Oncology Practice concludes that the ICD-10 transition may lead to both information and financial losses for providers. Additionally, a report from Fitch Ratings predicts that the transition may have negative credit reverberations for some providers.

To learn more:
- here's the CMS announcement (.pdf)

Suggested Articles

Payers and providers have made significant investments in digitizing the healthcare system but have yet to see a return on that investment.

Fewer than 4 in 10 health systems can successfully share data with other health systems, which presents a number of challenges.

As telehealth programs continue to expand, it’s crucial to understand how facility management will shift with these advancements in healthcare.