February 24, 2014
Today at HIMSS14, I had the opportunity to sit down with Stacey Shagena, a CMS representative, to discuss the CMS approach to ICD-10 testing. We talked about the ICD-10 testing program, and I asked her specifically to comment on why CMS has changed its long-held stance that the Medicare program did not need to perform ICD-10 provider testing. Stacey said:
“Simply put, we listened. The industry was very vocal about wanting this testing, and CMS wanted to be responsive to those requests. From our perspective, the coding has been finished since October 2013, we have spent thousands of hours on internal testing, and we have great confidence in our capabilities. Nevertheless, the industry wanted testing, and we decided to be responsive to that.”
CMS has indicated that there will be three opportunities for provider testing over the coming months.
The first testing period will be acknowledgement testing March 3 – 7. CMS will receive test claims, and process those claims through front-end system edits. CMS will respond to providers by acknowledging receipt of correctly formatted claims.
Over 2,500 organizations have already signed up to test March 3 – 7, representing a broad cross-section of hospitals, large physicians practices, and clearing houses. This testing period is still open, and anyone who submits a claim can participate.
The second testing opportunity will be sometime in May, when CMS will conduct another week of acknowledgement testing for organizations who were not ready or successful in testing during the March period. The specific week will be announced sometime this week at HIMSS, possibly during a scheduled presentation to the HIMSS general assembly on Thursday morning, February 27th by Marilyn Tavener, the Administrator for the Center for Medicare and Medicaid Services.
For organizations who can’t participate in either scheduled acknowledgement testing period, the individual Medicare Administrative Contractors (MACs) will be able to set up other opportunities for testing for them outside of the formal testing windows. Providers who need to take advantage of this should contact their MAC directly.
Finally, in late July, CMS will conduct limited end-to-end testing. Because of the effort and expense required to fully process test claims, this testing will be limited to “a statistically sample of the provider community.” This end-to end testing will involve the full claims adjudication process, and providers will receive 835 acknowledgements of their adjudicated claims.
Stacey concluded by reiterating that CMS has great confidence that the testing will go well, but that they are glad to provide these testing opportunities to reassure the industry.