ICD-10 News: Types of Testing

News Updates | July 23, 2015
About Acknowledgement and End-to-End Testing While ICD-10 is almost here, you still have time to get ready. But you must get ready now. Each day this week we are highlighting 1 of the 5 recommendations to help you begin testing: 1) Why Test Now, 2) How to Get Started, 3) Testing with Trading Partners, 4) Types of Testing, and 5) Testing Tips. Today our focus is: Type of Testing   Acknowledgement Testing  In acknowledgement testing, providers and other submitters, like clearinghouses, submit claims with ICD-10 codes and ICD-10 companion qualifiers. While claims are not adjudicated, submitters receive an acknowledgement that their claim was accepted or rejected. Tip: Be sure to use ICD-10 qualifiers, which differ from ICD-9 qualifiers. Some providers have reported that ICD-10 qualifiers had to be manually set up in their systems. Beyond testing with Medicare as described below, you can check with your commercial health plans, clearinghouses, and billing services for more acknowledgement testing opportunities. Medicare FFS Acknowledgement Testing All Medicare fee-for-service (FFS) providers who submit electronic claims can conduct acknowledgement testing with their Medicare Administrative Contractor (MAC) at any time untilSeptember 30: You do not need to register to participate You may submit an unlimited number of claims You can acknowledgement test claims directly or through a clearinghouse or billing agency To submit claims for testing, you must use: Current dates of service The test indicator “T” in the Interchange Control Structure (ISA) 15 field Analysis of acknowledgement testing to date has found no issues with Medicare systems for FFS claims. Rejected claims have been largely due to improperly prepared test claims—issues unrelated to ICD-10. Specific issues have been: An invalid National Provider Identifier (NPI), or an NPI that is not on the NPI crosswalk Invalid Healthcare Common Procedure Coding System (HCPCS) codes on professional claims Invalid postal ZIP codes on professional claims End-to-End Testing During end-to-end testing, providers submit claims containing valid ICD-10 codes. Health plans process the claims through system edits to return an electronic remittance advice (ERA). While registration has closed for the Medicare FFS end-to-end testing described below, some health plans continue to offer opportunities. If you have not conducted end-to-end testing yet, check with your health plans, clearinghouses, and billing services about opportunities. Medicare FFS End-to-End Testing Medicare’s last round of end-to-end testing is taking place this week, ending tomorrow, July 24. Advance registration was required to participate. Medicare FFS end-to-end testing is no longer open to new volunteers. (Please note that volunteers who took part in the January or April end-to-end testing are able to participate in the current testing, even if they did not register for July). Results from the July will be analyzed and released next month. Results from the last round of Medicare FFS end-to-end testing, held April 27 to May 1, showed that overall, participants were able to successfully submit ICD-10 test claims and have them processed through the Medicare billing systems. Testers included providers, clearinghouses, and billing agencies. CMS was able to accommodate most volunteers, representing a broad cross-section of provider, claim, and submitter types. The acceptance rate for April was higher than for January, with an increase in test claims submitted and a decrease in the percentage of errors related to either ICD-9 or ICD-10 codes: 23,138 test claims received 20,306 test claims accepted 88% acceptance rate 2% of test claims rejected due to invalid submission of ICD-10 diagnosis or procedure codes <1% of test claims rejected due to invalid submission of ICD-9 diagnosis or procedure codes Additional rejections were from non-ICD-10 related errors, including: Incorrect NPI Incorrect Health Insurance Claim Number Incorrect submitter ID Dates of service outside the valid range for testing Invalid HCPCS codes Invalid place of service Testing has demonstrated that CMS systems are ready to accept ICD-10 claims. To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals. Keep Up to Date on ICD-10Visit the CMS ICD-10 website and Roadto10.org for the latest news and resources to help you prepare. Sign up for and CMS ICD-10 Industry Email Updates and follow us on Twitter.
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Administrative Simplification Reminder: Final Chance to Provide Feedback for Health Plan Identifier RFI

Time Is Running Out: Submit Your Comments on the HPID Request for Information Time is running out to submit your comments in response to the Department of Health and Human Services (HHS) Health Plan Identifier (HPID) (RFI) on the Health Plan Identifier (HPID). The comment period closes on Tuesday, July 28, 2015. The intent of the HPID RFI is to collect perspectives from all segments of the industry on the current HPID policy in order to determine future policy directions.  This RFI seeks information from the health care industry about: The HPID enumeration structure outlined in the HPID final rule, including the use of the controlling health plan (CHP)/subhealth plan (SHP) and other entity identifier (OEID) concepts. The use of the HPID in Health Insurance Portability and Accountability Act (HIPAA) transactions in conjunction with the Payer ID. Whether changes to the nation's health care system, since the issuance of the HPID final rule published September 5, 2012, have altered your perspectives about the function of the HPID. Submit Your Comments The 60-day public comment period closes July 28, 2015. Any member of the public may submit comments. Comments can be submitted in several ways, including via electronic submission or mail: Electronically You may submit electronic comments to http://www.regulations.gov. By regular mail By express or overnight mail By hand or courier Electronic submission is encouraged. Subscriber Services: Manage Preferences | Unsubscribe

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.

ICD-10: Register Now for the Last Call Before Implementation

The MLN Connects® Provider eNews contains important news, announcements, and updates for health care professionals. Thursday, July 23, 2015 Can't view the image? Read the eNews! View this edition as a PDF In This Edition: Countdown to ICD-10 ICD-10 Is Less than 70 Days Away: Get Ready Are Non-HIPAA Covered Entities Required to Transition to ICD-10? MLN Connects National Provider Call: Countdown to ICD-10 Video: 10 Facts about ICD-10 MLN Connects® National Provider Calls and Events ESRD QIP: Proposed Rule for Payment Year 2019 Call — Last Chance to Register Proposed Reform of Requirements for Long-Term Care Facilities Call — Registration Now Open Hospital Compare Overall Star Ratings Methodology Call — Register Now New MLN Connects National Provider Call Audio Recordings and Transcripts Associations and Organizations Providing Credit for MLN Connects Events Announcements CMS Releases First Round of Home Health Compare Quality of Patient Care Star Ratings CMS Announces Medicare Care Choices Model Awards LTCH QRP Data Submission Deadline: August 15 IRF QRP Data Submission Deadline: August 15 Updated Open Payments CME Guidance eCQM: 2016 QRDA Implementation Guide Now Available Claims, Pricers, and Codes July 2015 OPPS Pricer File Update Medicare Learning Network® Educational Products "Medicare Quarterly Provider Compliance Newsletter [Volume 5, Issue 4]" Educational Tool — Released “Home Oxygen Therapy” Booklet — Released “The Basics of DMEPOS Accreditation” Fact Sheet — Revised "Medical Privacy of Protected Health Information" Fact Sheet — Reminder "Avoiding Medicare Fraud and Abuse:  A Roadmap for Physicians” Web-Based Training Course — Reminder Medicare Learning Network Products Available In Electronic Publication Format New Continuing Education Organization Now Accepting Medicare Learning Network Web-Based Training Courses Like the eNews? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).

ICD-10 News: Testing with Trading Partners

News Updates | July 22, 2015
Test with Vendors, Billing Services, Clearinghouses, Health Plans While ICD-10 is almost here, you still have time to get ready. But you must get ready now. Each day this week we are highlighting 1 of the 5 recommendations to help you begin testing: 1) Why Test Now, 2) How to Get Started, 3) Testing with Trading Partners, 4) Types of Testing, and 5) Testing Tips. Today our focus is: Testing With Trading Partners   Test with vendors, clearinghouses, billing services, and health plans to: Verify that you can submit, receive, and process data with ICD-10 codes Understand how ICD-10 updates affect the transactions you submit Identify and address specific issues before October 1 Because time is short, test inside your practice and with partners at the same time if you are just getting started. Check for testing opportunities at the website of the Cooperative Exchange, an association of clearinghouses. To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals. Keep Up to Date on ICD-10Visit the CMS ICD-10 website and Roadto10.org for the latest news and resources to help you prepare. Sign up for and CMS ICD-10 Industry Email Updates and follow us on Twitter.
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ICD-10 News: How to Start Testing

News Updates | July 21, 2015
Testing: How to Get Started While ICD-10 is almost here, you still have time to get ready. But you must get ready now. Each day this week we are highlighting 1 of the 5 recommendations to help you begin testing: 1) Why Test Now, 2) How to Get Started, 3) Testing with Trading Partners, 4) Types of Testing, and 5) Testing Tips. Today our focus is: How To Get Started   Verify that you can use your ICD-10-ready systems to: Generate a claim Schedule an outpatient procedure Perform eligibility and benefits verification Prepare to submit quality data Schedule an office visit Update a patient’s history and problems Code a patient encounter To get started, map out your workflows to help you decide what to test. Test any system that stores, processes, sends, receives, or reports diagnosis code information. Test your systems and workflow processes using ICD-10 diagnosis codes. You can test: Inside your practice With vendors, clearinghouses, billing services, and health plans Focus on your highest-risk scenarios. For example, claims processing and the diagnoses you see most often. Tips Involve financial and administrative staff Allow time to address any issues you uncover If you are participating in Medicare Fee-for-Service end-to-end testing this week, you can find additional information in these resources: MLN Matters SE1435 - End-to-End Testing FAQs MLN Matters SE1501 - Acknowledgement Testing and End-to-End Testing FAQs To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals. Keep Up to Date on ICD-10Visit the CMS ICD-10 website and Roadto10.org for the latest news and resources to help you prepare. Sign up for and CMS ICD-10 Industry Email Updates and follow us on Twitter.
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ICD-10 News: Test and Get Ready Now

News Updates | July 20, 2015
Test Your Systems and Processes While ICD-10 is less than 75 days away, you still have time to get ready. But you must get ready now. Each day this week we are sharing the why’s and how’s of ICD-10 testing: 1) Why Test Now, 2) How to Get Started, 3) Testing with Trading Partners, 4) Types of Testing, and 5) Testing Tips. Today our focus is: Why Test Now?   Why is it important to test now? Testing is vital to making sure you can create and submit claims using ICD-10 once we reach the compliance date. The only way to be sure that your systems can handle ICD-10 is to test. The earlier you test, the more time you have to resolve any issues you encounter during the claims creation process, which lasts from documentation to claims submission. Testing is one of the best ways to make sure you avoid potential cash flow issues. To learn more about getting ready, visit the cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals. Keep Up to Date on ICD-10Visit the CMS ICD-10 website and Roadto10.org for the latest news and resources to help you prepare. Sign up for and CMS ICD-10 Industry Email Updates and follow us on Twitter.
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