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CMS will run Medicare claims with ICD-10 codes through 'end-to-end' testing

The CMS will offer “end-to-end” testing of Medicare claims using the ICD-10 diagnostic and procedure codes, an attempt to deliver much sought-after assurances that its contractors will be prepared for the Oct. 1 implementation date.

The testing will allow the participating providers and suppliers to submit test claims to the CMS with ICD-10 codes and receive a remittance advice explaining how the claims were processed, according to the CMS.

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.

Follow Joseph Conn on Twitter: @MHJConn



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