Most providers have already marked October 1, 2014 on their calendars in red pen, but those concerned about Medicare claims processing and reimbursements should add another date to the ICD-10 timeline. During the relatively short window of March 3 and March 7, 2014, providers will be able to conduct ICD-10 testing through their local Medicare Administrative Contractors (MACs).
While this brief period of front-end testing may not solve all the problems providers will encounter during the ICD-10 transition, it does provide an opportunity to practice the basics in advance of the hard deadline. Here is a summary of what you will need to know if your organization plans to participate.
How do I register?
Each MAC is required by CMS to publicize the testing week activities through emails and listservs. You should be able to find registration information on your individual MAC’s website. If you don’t know who your MAC is, you can look it up in the CMS directory here. Registration should already be available.
What do I need to have on hand in order to conduct testing?
In order to conduct testing, you must have coded ICD-10 test Medicare claims ready to go. The claims must have dates of service between October 1, 2013 and March 3, 2014 in order to be processed. Claims with future dates of service will not be accepted by the system.
This front-end testing will not help your coders prepare their ICD-10 claims, nor will it help ensure the capabilities of your IT hardware and software to handle ICD-10 codes. It will not test initial connectivity to the MAC system. In order to meaningfully participate in this round of testing, you must already ensure that your internal systems are already capable of accepting, storing, and transmitting ICD-10 codes.
How do I submit my test claims?
The test data will be submitted through the Common Edits and Enhancements Module (CEM) or Common Electronic Data Interchange (CEDI). CMS has required all MACs to provide technical support for all business partners. Help desk personnel will be available, at minimum, from 9:00 AM to 4:00 PM local contractor time to assist organizations with their submissions. MACs have been asked to provide enough extra support to handle all the increased calls expected during the process, but as with any technical support hotline, providers should be aware that it may take time to resolve issues.
What information will I receive from my MAC?
Unfortunately, this testing process will not provide any constrictive criticism for providers. The only information that the MACs will be giving partners is a 277CA or 999 acknowledgement that the claim was either accepted or rejected. MACs will not provide confirmation of claim payment or produce remittance advice.
This means MACs will not be able to tell providers what needs to be done in order to ensure payment. They will not be able to comment on your coding skills or documentation integrity. This is purely a technical test to ensure that claims can get from the provider to the Medicare system.
How do I use this information to complete my ICD-10 prep?
This testing week will be most useful for providers who already understand the ICD-10 process and have already completed significant steps towards compliance. Its purpose is simply to ensure that the technical work they have done will pay off after October 1, 2014.
For providers who are unsure if they are coding to the highest level of specificity required by the new code set, or who have not completed internal testing, the information provided by you MAC may not be of much use. Concerns about coding competencies, or questions about why a claim is incomplete, should be addressed by your ICD-10 consultants or clinical documentation improvement managers.
CMS is considering providing the opportunity for more thorough testing before October 1, 2014, due to industry-wide concerns about a lack of preparedness and difficulties bringing documentation up to par. However, providers cannot count on the fact that end-to-end testing with Medicare will be available, and should prepare themselves accordingly.
Date: February 3, 2014