CMS to do ICD-10 testing after all

February 20, 2014 in Medical Technology


Some people will invariably take this as proof that ICD-10 will not be pushed back any further — while others will suggest it serves as evidence that the Centers for Medicare and Medicaid Services cannot be taken at its word.

Despite maintaining that it would not do so — and after industry pressure from several directions including the American Medical Association just last week — CMS revealed late Wednesday plans to conduct end-to-end testing for ICD-10, after all.

In a Medicare Learning Network MLN Matters news flash, CMS explained that “in summer 2014, CMS will offer end-to-end testing to a small sample group of providers,” adding that “details about the end-to-end testing process will be disseminated at a later date.”

The end-to-end testing CMS describes includes providers sending test claims using ICD-10 codes and CMS returning a Remittance Advice (RA) to outline any claims adjudication.

CMS outlined the goals for this manner of testing as demonstrating: providers and submitters ability to send claims in ICD-10 to Medicare FFS systems, that the changes CMS made to its own software support ICD-10 and return claims that are appropriately adjudicated and produce accurate RAs.

[See also: As 2014 begins, ICD-10 deadline looms.]

“The small sample group of providers who participate in end-to-end testing will be selected to represent a broad cross-section of provider types, claims types, and submitter types,” CMS wrote.

Which is at least somewhat resembling what the AMA called for when, in a Feb 12. letter to HHS Secretary Kathleen Sebelius, the association urged CMS to conduct “true” end-to-end testing, if not for all physicians, then for at least 100 different practices of varying size and specialty.

[See also: ICD-10 cost a ‘crushing burden’ for docs.]

In that letter the AMA also “strongly urges CMS to reconsider the ICD-10 mandate.”

And while there is next to no evidence CMS is really going to rethink ICD-10 at this point — which is not to suggest that no one else holds sway over the code set ultimate fate — the fact that it will engage in this manner of end-to-end testing and ultimately share details about what it learned should be taken as welcome evidence that the agency can be pragmatic when necessary.

This analysis was first published in our sister publication, Governement Health IT News.

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