ICD-10 News: Volunteer for End-to-End Testing in April — Forms Due January 9

News Updates | December 30, 2014
Volunteer for ICD-10 End-to-End Testing in April — Forms Due January 9 During the week of April 26 through May 1, 2015, a second sample group of providers will have the opportunity to participate in ICD-10 end-to-end testing with Medicare Administrative Contractors (MACs) and the Common Electronic Data Interchange (CEDI) contractor. The goal of end-to-end testing is to demonstrate that: Providers and submitters are able to successfully submit claims containing ICD-10 codes to the Medicare Fee-For Service (FFS) claims systems Centers for Medicare & Medicaid Services (CMS) software changes made to support ICD-10 result in appropriately adjudicated claims Accurate remittance advices are produced Approximately 850 volunteer submitters will be selected to participate in the April end-to-end testing. This nationwide sample will yield meaningful results, since CMS intends to select volunteers representing a broad cross-section of provider, claim, and submitter types, including claims clearinghouses that submit claims for large numbers of providers. Note: testers who are participating in the January testing are able to test again in April and July without re-applying. To Volunteer as a Testing Submitter: Volunteer forms are available on your MAC website. Completed volunteer forms are due January 9. CMS will review applications and select the group of testing submitters. By January 30, the MACs and CEDI will notify the volunteers selected to test and provide them with the information needed for the testing. If Selected, Testers Must Be Able To: Submit future-dated claims. Provide valid National Provider Identifiers (NPIs), Provider Transaction Access Numbers (PTANs), and beneficiary Health Insurance Claim Numbers (HICNs) that will be used for test claims. This information will be needed by your MAC by February 20, 2015, for set-up purposes; testers will be dropped if information is not provided by the deadline. An additional opportunity for end-to-end testing will be available during the week ofJuly 20 through 24, 2015. Any issues identified during testing will be addressed prior to ICD-10 implementation. Educational materials will be developed for providers and submitters based on the testing results.For more information: MLN Matters® Special Edition Article #SE1409, “Medicare FFS ICD-10 Testing Approach.” MLN Matters® Special Edition Article #SE1435, “FAQs – ICD-10 End-to-End Testing” Keep Up to Date on ICD-10Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
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Holding of 2015 Date-of-Service Claims and DMEPOS Competitive Bidding Registration Reminder

The MLN Connects™ Provider eNews contains important news, announcements, and updates for health care professionals. Monday, December 29, 2014 Holding of 2015 Date-of-Service Claims for Services Paid Under the 2015 Medicare Physician Fee  On November 13, 2014, the CY 2015 Medicare Physician Fee Schedule (MPFS) final rule was published in the Federal Register. In order to implement corrections to technical errors discovered after publication of the MPFS rule and process claims correctly, Medicare Administrative Contractors will hold claims containing 2015 services paid under the MPFS for the first 14 calendar days of January 2015 (i.e., Thursday January 1 through Wednesday January 14). The hold should have minimal impact on provider cash flow as, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. MPFS claims for services rendered on or before Wednesday Dec 31, 2014 are unaffected by the 2015 claims hold and will be processed and paid under normal procedures and time frames.  Registration Reminder for DMEPOS Competitive Bidding: Round 2 Recompete & National Mail-Order Recompete CMS would like to remind all suppliers that registration is now open for those interested in participating in the Round 2 Recompete and/or the national mail-order recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. In order to submit a bid(s) for the Round 2 Recompete and/or the national mail-order recompete, you must first register in the Individuals Authorized Access to CMS Computer Services (IACS) online application. Once you have registered in IACS, you will receive a user ID and password to access the online DMEPOS Bidding System (DBidS). You must register even if you registered during a previous round of competition (Round 1 Recompete, Round 2, or the national mail-order competition). Only suppliers who have a user ID and password will be able to access DBidS; suppliers that do not register will not be able to submit a bid. If you are a supplier interested in bidding, you must designate one individual listed as an authorized official (AO) on your organization’s CMS-855S enrollment application in the Provider Enrollment, Chain, and Ownership System (PECOS) to act as your AO for registration purposes. After an AO successfully registers, other individuals listed as an AO on the CMS-855S in PECOS may register as backup authorized officials (BAOs).The AO must approve a BAO’s request to register. The AO and BAOs can designate other individuals not listed as an AO on the CMS-855S in PECOS to serve as end users (EUs).BAOs and EUs must also register for a user ID and password in IACS in order to access DBidS. The name and Social Security number of the AO and BAO entered in IACS must match exactly with what is recorded on the CMS-855S and on file in PECOS to register successfully. Bidders are prohibited from sharing user IDs and passwords. CMS strongly urges all AOs to register no later than January 6, 2015, to ensure that BAOs and EUs have time to register. We recommend that BAOs register no later than January 20, 2015, so that they will be able to assist AOs with approving EU registration before bidding begins on January 22, 2015. Registration extends into the bidding period and will close on Tuesday, February 17, 2015 at 9pm prevailing ET– no AOs, BAOs, or EUs can register after registration closes. Bidding will close on Wednesday, March 25, 2015. To register, go to the Competitive Bidding Implementation Contractor (CBIC) website,www.dmecompetitivebid.com, click on Round 2 & National Mail-Order Recompete, and then click on "Registration is Open” above the Registration clock. CMS strongly recommends that you: Review the IACS Reference Guide, Watch the short and very helpful instructional video, “How to Register to Submit a Bid,” on your computer, tablet, or phone, and Use the IACS: Getting Started Registration Checklist. CMS would also like to remind you to: Review and update your enrollment records. Suppliers must maintain accurate information on their CMS-855S enrollment application with the National Supplier Clearinghouse (NSC) and in PECOS. It is important to note that if your record is not current at the time of registration, you may experience delays and/or be unable to register and bid. We will also validate your bid data against your enrollment record in PECOS during bid evaluation. If it is not current or accurate, your bid(s) may be disqualified. Get licensed. Supplier locations must be licensed as applicable by the state in which it furnishes, or will furnish, products and services under the DMEPOS Competitive Bidding Program. Get accredited. Supplier locations must be accredited by a CMS-approved accrediting organization for the products and services it furnishes, or will furnish, under the DMEPOS Competitive Bidding Program. The CBIC is the official information source for bidders. All suppliers interested in bidding are urged to sign up for E-mail Updates on the home page of the CBIC website. For information about the Round 2 Recompete and the national mail-order recompete, please refer to the bidder education materials located under Round 2 & National Mail-Order Recompete > Bidding Suppliers on this website. The CBIC participates in numerous educational events to assist stakeholders in understanding the rules that govern the DMEPOS Competitive Bidding Program. Visit the CBIC website for a listing and schedule of educational events under the Educational Information section of the Round 2 & National Mail-Order Recompete page. In addition to viewing the information on the CBIC website, suppliers are encouraged to call the CBIC customer service center toll-free, at 877-577-5331, with their questions. During registration and bidding periods, the customer service center will be open from 9am to 9pm ET.

Results from November ICD-10 Acknowledgement Testing Week

News Updates | December 23, 2014
Results from November ICD-10 Acknowledgement Testing Week CMS conducted another successful acknowledgement testing week last month. Acknowledgement testing gives providers and others the opportunity to submit claims with ICD-10 codes to the Medicare Fee-For-service (FFS) claims systems and receive electronic acknowledgements confirming that their claims were accepted. While providers are welcome to submit acknowledgement test claims anytime, during the November testing week, testers submitted almost 13,700 claims. More than 500 providers, suppliers, billing companies, and clearinghouses participated in the testing week last month. Testers included small and large physician practices, small and large hospitals, labs, ambulatory surgical centers, dialysis facilities, home health providers, ambulance providers, and several other physician specialties. Acceptance rates improved throughout the week with Friday’s acceptance rate for test claims at 87 percent. Nationally, CMS accepted 76 percent of total test claims. Testing did not identify any issues with the Medicare FFS claims systems. This testing week allowed an opportunity for testers and CMS alike to learn valuable lessons about ICD-10 claims processing. To ensure a smooth transition to ICD-10, CMS verified all test claims had a valid diagnosis code that matched the date of service, a National Provider Identifier (NPI) that was valid for the submitter ID used for testing, and an ICD-10 companion qualifier code to allow for processing of claims. In many cases, testers intentionally included errors in their claims to make sure that the claim would be rejected, a process often referred to as “negative testing.” The majority of rejections on professional claims were common rejects related to an invalid NPI. Some claims were rejected because they were submitted with future dates. Acknowledgement testing cannot accept claims for future dates. Additionally, claims using ICD-10 must have an ICD-10 companion qualifier code. Claims that did not meet these requirements were rejected. Mark your calendar for upcoming acknowledgement testing weeks on March 2-6, 2015and June 1-5, 2015. In addition to the special testing weeks, providers are welcome to submit acknowledgement test claims anytime up to the October 1, 2015implementation date. Contact your Medicare Administrative Contractor for more information. For more information: MLN Matters® Article MM8858, "ICD-10 Testing - Acknowledgement Testing with Providers” MLN Matters® Special Edition Article SE1409, “Medicare FFS ICD-10 Testing Approach,” which also includes information on opportunities for end-to-end testing with FFS Medicare Keep Up to Date on ICD-10Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
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ICD-10 Testing Results and DMEPOS Competitive Bidding Registration Reminder

The MLN Connects™ Provider eNews contains important news, announcements, and updates for health care professionals. Monday December 22, 2014 Results from November ICD-10 Acknowledgement Testing Week CMS conducted another successful acknowledgement testing week last month. Acknowledgement testing gives providers and others the opportunity to submit claims with ICD-10 codes to the Medicare Fee-For-service (FFS) claims systems and receive electronic acknowledgements confirming that their claims were accepted. While providers are welcome to submit acknowledgement test claims anytime, during the November testing week, testers submitted almost 13,700 claims. More than 500 providers, suppliers, billing companies, and clearinghouses participated in the testing week last month. Testers included small and large physician practices, small and large hospitals, labs, ambulatory surgical centers, dialysis facilities, home health providers, ambulance providers, and several other physician specialties. Acceptance rates improved throughout the week with Friday’s acceptance rate for test claims at 87 percent. Nationally, CMS accepted 76 percent of total test claims. Testing did not identify any issues with the Medicare FFS claims systems. This testing week allowed an opportunity for testers and CMS alike to learn valuable lessons about ICD-10 claims processing. To ensure a smooth transition to ICD-10, CMS verified all test claims had a valid diagnosis code that matched the date of service, a National Provider Identifier (NPI) that was valid for the submitter ID used for testing, and an ICD-10 companion qualifier code to allow for processing of claims. In many cases, testers intentionally included errors in their claims to make sure that the claim would be rejected, a process often referred to as “negative testing.” The majority of rejections on professional claims were common rejects related to an invalid NPI. Some claims were rejected because they were submitted with future dates. Acknowledgement testing cannot accept claims for future dates. Additionally, claims using ICD-10 must have an ICD-10 companion qualifier code. Claims that did not meet these requirements were rejected. Mark your calendar for upcoming acknowledgement testing weeks on March 2-6, 2015 and June 1-5, 2015. In addition to the special testing weeks, providers are welcome to submit acknowledgement test claims anytime up to the October 1, 2015 implementation date. Contact your Medicare Administrative Contractorfor more information. For more information: MLN Matters® Article MM8858, "ICD-10 Testing - Acknowledgement Testing with Providers” MLN Matters® Special Edition Article SE1409, “Medicare FFS ICD-10 Testing Approach,” which also includes information on opportunities for end-to-end testing with FFS Medicare Registration Reminder for DMEPOS Competitive Bidding: Round 2 Recompete & National Mail-Order Recompete CMS would like to remind all suppliers that registration is now open for those interested in participating in the Round 2 Recompete and/or the national mail-order recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. In order to submit a bid(s) for the Round 2 Recompete and/or the national mail-order recompete, you must first register in the Individuals Authorized Access to CMS Computer Services (IACS) online application. Once you have registered in IACS, you will receive a user ID and password to access the online DMEPOS Bidding System (DBidS). You must register even if you registered during a previous round of competition (Round 1 Recompete, Round 2, or the national mail-order competition). Only suppliers who have a user ID and password will be able to access DBidS; suppliers that do not register will not be able to submit a bid. If you are a supplier interested in bidding, you must designate one individual listed as an authorized official (AO) on your organization’s CMS-855S enrollment application in the Provider Enrollment, Chain, and Ownership System (PECOS) to act as your AO for registration purposes. After an AO successfully registers, other individuals listed as an AO on the CMS-855S in PECOS may register as backup authorized officials (BAOs).The AO must approve a BAO’s request to register. The AO and BAOs can designate other individuals not listed as an AO on the CMS-855S in PECOS to serve as end users (EUs).BAOs and EUs must also register for a user ID and password in IACS in order to access DBidS. The name and Social Security number of the AO and BAO entered in IACS must match exactly with what is recorded on the CMS-855S and on file in PECOS to register successfully. Bidders are prohibited from sharing user IDs and passwords. CMS strongly urges all AOs to register no later than January 6, 2015, to ensure that BAOs and EUs have time to register. We recommend that BAOs register no later than January 20, 2015, so that they will be able to assist AOs with approving EU registration before bidding begins on January 22, 2015. Registration extends into the bidding period and will close on Tuesday, February 17, 2015 at 9pm prevailing ET– no AOs, BAOs, or EUs can register after registration closes. Bidding will close on Wednesday, March 25, 2015. To register, go to the Competitive Bidding Implementation Contractor (CBIC) website,www.dmecompetitivebid.com, click on Round 2 & National Mail-Order Recompete, and then click on "Registration is Open” above the Registration clock. CMS strongly recommends that you: Review the IACS Reference Guide, Watch the short and very helpful instructional video, “How to Register to Submit a Bid,” on your computer, tablet, or phone, and Use the IACS: Getting Started Registration Checklist. CMS would also like to remind you to: Review and update your enrollment records. Suppliers must maintain accurate information on their CMS-855S enrollment application with the National Supplier Clearinghouse (NSC) and in PECOS. It is important to note that if your record is not current at the time of registration, you may experience delays and/or be unable to register and bid. We will also validate your bid data against your enrollment record in PECOS during bid evaluation. If it is not current or accurate, your bid(s) may be disqualified. Get licensed. Supplier locations must be licensed as applicable by the state in which it furnishes, or will furnish, products and services under the DMEPOS Competitive Bidding Program. Get accredited. Supplier locations must be accredited by a CMS-approved accrediting organization for the products and services it furnishes, or will furnish, under the DMEPOS Competitive Bidding Program. The CBIC is the official information source for bidders. All suppliers interested in bidding are urged to sign up for E-mail Updates on the home page of the CBIC website. For information about the Round 2 Recompete and the national mail-order recompete, please refer to the bidder education materials located under Round 2 & National Mail-Order Recompete > Bidding Suppliers on this website. The CBIC participates in numerous educational events to assist stakeholders in understanding the rules that govern the DMEPOS Competitive Bidding Program. Visit the CBIC website for a listing and schedule of educational events under the Educational Information section of the Round 2 & National Mail-Order Recompete page. In addition to viewing the information on the CBIC website, suppliers are encouraged to call the CBIC customer service center toll-free, at 877-577-5331, with their questions. During registration and bidding periods, the customer service center will be open from 9am to 9pm ET.

ICD-10 News: Clinical Documentation Improvement Webinar Recording Available

News Updates | December 19, 2014
Clinical Documentation Improvement Webinar Recording Available The Centers for Medicare & Medicaid Services (CMS) recently collaborated with the American Health Information Management Association (AHIMA) to present a webinar on clinical documentation improvement. Watch the recording to learn about: Why detailed clinical documentation is important for the ICD-10 transition Steps for training your staff Additional resources and information To access the recording, please register for the webinar. A PDF of the presentationand frequently asked questions about ICD-10 are also available on the ICD-10 page of the AHIMA website. DISCLAIMER: The content of this presentation does not supersede published CMS policy. CMS does not explicitly endorse the accuracy of all answers provided by the presenters and/or other participants. Keep Up to Date on ICD-10Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
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Physician Compare Update December 2014 Issue 2 Welcome to the December 2014 issue of Physician Compare Update from the Centers for Medicare and Medicaid Services (CMS). This publication is used to regularly communicate news, updates, alerts, and announcements about Physician Compare. We want to hear from you about topics of interest, so please email the team atPhysicianCompare@Westat.com.  Current Topics of Interest: Public Reporting of the 2013 Quality Measures Physician Compare Virtual Office Hour Session 2015 Physician Fee Schedule (PFS) Final Rule Physician Compare Technical Expert Panel Public Reporting of the 2013 Quality Measures:  On December 18, 2014, CMS publicly reported the 2013 Physician Quality Reporting System (PQRS) Group Practice Reporting Option (GPRO) measures for 139 group practices, 214 Shared Savings Program Accountable Care Organizations (ACOs), and 23 Pioneer ACOs. The data are reported at the group practice and ACO level.  The specific measures being reported are: Controlling blood sugar levels in patients with diabetes (GPRO DM-15: Diabetes Mellitus: Hemoglobin A1c Control (<8%)). Controlling blood pressure in patients with diabetes (GPRO DM-13: Diabetes Mellitus: Blood Pressure Control in Patients with Diabetes). Prescribing aspirin to patients with diabetes and heart disease (GPRO DM-16: Diabetes Mellitus: Daily Aspirin Use for Patients with Diabetes and Ischemic Vascular Disease). Prescribing medicine to improve the pumping action of the heart in patients who have both heart disease and certain other conditions (GPRO CAD-7. Coronary Artery Disease (CAD): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Patients with CAD and Diabetes and/or Left Ventricular Systolic Dysfunction (LVSD)). In addition to PQRS measures, CMS publicly reported the first set of patient experience measures for ACOs on Physician Compare.  The data are based on patients’ responses to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for ACOs survey.  The specific summary survey measures include: Getting Timely Care, Appointments, and Information How Well Your Doctors Communicate Patients’ Rating of Doctor Health Promotion and Education CMS will phase in additional quality measures on Physician Compare over the next several years. The 2014 PFS Final Rule further expands on the public reporting plan to make available for public reporting all PQRS GPRO measures collected via the Web Interface, registry, and EHR; all ACO measures; a subset of PQRS individual eligible professional measures collected through an EHR, registry, or claims; and patient experience measures, specifically CAHPS for PQRS and CAHPS for ACOs. These data are targeted for publication in late 2015. For more information about the 2013 GPRO and ACO measures and the public reporting plan, go to the Physician Compare Initiative webpage. <back to top> Physician Compare Virtual Office Hour Session: CMS will be hosting a Physician Compare Virtual Office Hour session on January 22, 2015. This session will provide CMS the opportunity to directly address questions about Physician Compare and public reporting. The session will be conducted via WebEx from 11:30am – 12:30pm EST. You can register for the session by emailing the Physician Compare support team at PhysicianCompare@Westat.com. Please use the subject line “Physician Compare Virtual Office Hour” and include your name, organization, telephone number, and email address. All questions will be solicited in advance. Please include your questions with your registration email or send them separately to the e-mail above when prepared. In order to address as many participants as possible, you may submit up to three questions. All questions must be received by 5:00pm EST on Wednesday, January 14, 2015. <back to top> 2015 Physician Fee Schedule (PFS) Final Rule: On November 13, 2014, CMS released the 2015 Physician Fee Schedule (PFS) final rule (79 FR 67547) which continues to build on the phased approach for public reporting on Physician Compare. CMS has purposefully laid out this phased, transparent approach to public reporting to ensure reporting is accurate and the measures reported are helpful to consumers as they make important decisions about their health care.  According to the rule, CMS will expand public reporting of group-level measures by making all 2015 PQRS GRPO Web Interface, registry, and EHR measures for group practices of two or more eligible professionals (EPs) and all measures reported by ACOs available for public reporting on Physician Compare in late 2016. All 2015 PQRS individual EP-level measures collected via registry, EHR, or claims will also be available for public reporting on Physician Compare in late 2016. Individual EP-level Qualified Clinical Data Registry (QCDR) measures will be available for public reporting, too, with the exception of those measures that are new and thus in their first year of use. In general, no first year measures will be publicly reported on Physician Compare. All measures submitted, reviewed, and deemed valid and reliable will be reported in the Physician Compare downloadable database; however, only those measures deemed most helpful and useful to consumers will be included on the Physician Compare profile pages. Understanding the value consumers place on data reported by patients like them, CMS will publicly report 2015 Consumer Assessment of Healthcare Providers and Systems (CAHPS) for PQRS survey data in late 2016 for group practices of two or more EPs, as well as CAHPS for ACO survey data, for those that meet the specified sample size requirements and collect data via an approved CMS-specified CAHPS vendor. In addition, the 2015 PFS rule finalized that individual EPs will receive a green checkmark indicating support for Million Hearts if they satisfactorily report all four of the following cardiovascular prevention individual measures: Ischemic Vascular Disease (IVD):  Use of Aspirin or Another Antithrombotic; Preventive Care and Screening:  Tobacco Use; Controlling High Blood Pressure; and Preventive Care and Screening:  Screening for High Blood Pressure and Follow-Up Documented. For more information on what was finalized for Physician Compare, review the 2015 PFS final rule athttps://federalregister.gov/a/2014-26183. Additional information on the Physician Compare public reporting plan can be found in the Public Reporting section of the Physician Compare Initiative webpage. <back to top> Physician Compare Technical Expert Panel:  In 2013, CMS convened the Physician Compare Quality Measurement Technical Expert Panel (TEP) to provide expert input regarding public reporting via the Physician Compare website. The TEP comprises 16 individuals who represent the perspectives of patients/caregivers and purchasers as well as technical experts who can provide a broad range of technical experience and expertise in public reporting of performance measures. The TEP convened at a third meeting on August 18, 2014. The purpose of the meeting was to seek the TEP’s input on the 2013 PQRS measures available for public reporting on Physician Compare. A summary of this meeting is now available on the Physician Compare Initiative webpage. <back to top>

Centers for Medicare & Medicaid Services (CMS) has sent this Medicare.gov- Physician Compare Update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.

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