WEDI guidance directs focus for ICD-10 testing

The Workgroup for Electronic Data Interchange (WEDI) has issued guidance to help the healthcare industry better understand where to focus transaction testing to ensure that ICD-10 codes are correctly placed and formatted within the transactions.

The issue brief--"ICD-10 Impact to HIPAA Transactions," prepared in collaboration with the Accredited Standards Committee X12 (ASC X12)--outlines the transactions affected by ICD-10, as well as the placement of the codes within the transactions.

ICD-10 will affect every business process and system in health plans, provider facilities, clearinghouses and vendor offerings, according to an announcement, so it's imperative that transactions include the proper diagnosis and procedure information.

"Although it can be argued that implementation of version 5010 of the ASC X12 transactions tested the format that will be used to carry ICD-10 codes, the industry did not focus on assuring the codes were correctly assigned and reflected on transactions or that transactions carrying ICD-10 codes were correctly processed in front end or downstream applications," the document states. "This document will help highlight the transactions and content that will need to be validated as part of the ICD-10 testing effort."

With the healthcare industry overall lagging behind proposed timelines for implementing ICD-10, Christine Armstrong, principal at Deloitte, has urged organizations to leave plenty of time for both internal and external testing. Her clients have found that testing takes far more time than they planned.

Yet research released in June by the Medical Group Management Association found that only 4.8 percent of more than 1,200 responding medical groups had made "significant" progress in their ICD-10 implementation efforts. The American Hospital Association and the Blue Cross Blue Shield Association, however, recently assured Congress that its members are on track to meet the Oct. 1, 2014, implementation deadline.

Though the Centers for Medicare & Medicaid Services is conducting end-to-end testing of its systems related to health insurance exchange, it has said it will not conduct external ICD-10 testing with business partners such as hospitals and payers.

To learn more:
- find the announcement
- download the issue brief (.pdf)

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