The goals are to demonstrate that providers or other submitters, such as claims clearinghouses, are able to successfully send claims containing ICD-10 codes to the Medicare fee-for-service claim systems; that CMS' software changes made to support ICD-10 result in appropriately adjudicated claims, based on the pricing data used for testing purposes; and that an accurate remittance advice is produced.
The CMS has been under pressure for months from various groups to require its claims processors to test claim flows both from and back to providers.
The decision to test “certainly is a good thing, subject to the details of course,” said health IT consultant Stanley Nachimson, author of a recent ICD-10 cost report for the American Medical Association. “But it looks like they're listening.”
Notice of the testing program for “a small sample group of providers,” was posted to the CMS' Medical Learning Network newsletter.
CMS previously announce a more limited round of external testing with providers scheduled to run March 3-7.
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