WEDI Offers ICD-10 Testing Advice for Small Physician Practices

March 4, 2015 in News

The Workgroup for Electronic Data Interchange has released a white paper to help practices with five or fewer physicians transition to ICD-10, Health Data Management reports (Slabodkin, Health Data Management, 3/3).

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets by Oct. 1 to accommodate codes for new diseases and procedures.

Details of White Paper

The white paper highlights the importance of conducting external testing with payers, EHR Intelligence reports.

According to the paper, such testing can help providers avoid issues when transitioning to ICD-10. Specifically, the paper states that testing can help prevent:

  • Cash flow disruption;
  • Claim denials and delays related to ICD-10 coding errors; and
  • The inability of electronic health record systems and other software applications to produce ICD-10 claims.

However, small practices face several challenges to completing such testing, including:

  • Lack of opportunities to test due to a limited number of testing slots;
  • Scarce provider resources for ICD-10 testing; and
  • Inadequate staff training.

Recommendations

The paper outlines several recommendations for how small practices can overcome these challenges. Specifically, WEDI advises staff at small practices to:

  • Confirm that their testing needs align with their payers’ testing;
  • Contact CMS and Medicare Administrative Contractors to register for testing;
  • Determine which payers are creating self-service, Web-based testing opportunities;
  • Follow instructions from the payer or billing service, paying special attention to qualifiers, headers and format items when incorporating new codes;
  • Identify which payers process the majority of claims and test ICD-10 readiness with those payers;
  • Review results, comparing data with predictions;
  • Speak with their EHR vendors and confirm all software products are ICD-10 compliant; and
  • Work with their billing service or clearinghouse to determine how they can assist with testing.

The white paper notes that CMS offers end-to-end testing from April 27 to May 1 and from July 20 to July 24. Further, the paper recommends that small practices create a timeline for ICD-10 preparations (Gruessner, EHR Intelligence, 3/2).

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