MGMA presses HHS for end-to-end ICD-10 testing

The Medical Group Management Association (MGMA) is urging the U.S. Department of Health & Human Services to conduct full end-to-end testing of ICD-10 to prevent cash-flow problems for physician practices.

In a letter to HHS Secretary Kathleen Sebelius this week, MGMA calls front-end testing "simply insufficient." It points to the problems with the adoption of HIPAA Version 5010 as an example that physician practices need to be better prepared.

MGMA cites three reasons more testing is required, including:

  • So that software developers can ensure the technology is appropriately configured for physician practices
  • To identify problems before the Oct. 1, 2014, compliance deadline and to allow business partners to make necessary adjustments to systems and workflow
  • To help practices better understand the impact ICD-10 will have on reimbursement

MGMA calls on Medicare to conduct more testing weeks, and to release results of testing as soon as possible afterward so vendors and providers can make adjustments. It's also requesting more outreach and education.

"If the transition to ICD-10 results in a wide-scale interruption to the nation's claim-processing system, the ability of healthcare providers to continue operations could be significantly impacted," the letter states. "While end-to-end testing will not ensure that this disruption will not take place, it will provide increased assurance to physician practices and other industry stakeholders that claims will be processed and highlight well before the compliance date any additional steps necessary for implementation."

The American Hospital Association also is urging end-to-end testing--and that it begin in January.

The National Pilot Program of ICD-10 coding conducted by the Healthcare Information and Management Systems Society (HIMSS) and the Workgroup for Electronic Data Interchange (WEDI) achieved an average accuracy rate of just 63 percent, finding plenty of room for improvement.

WEDI, meanwhile, has issued guidance to help providers better understand where to focus transaction testing to ensure that ICD-10 codes are correctly placed and formatted within the transactions.

To learn more:
- find the letter (.pdf)

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