ICD-10 Testing Drop-in Article

Medicare ICD-10 Acknowledgement Testing

The Centers for Medicare and Medicaid Services (CMS) is in the process of implementing ICD-10. All covered entities must be fully compliant on October 1, 2015. CR8858 instructs all Medicare Administrative Contractors (MACs) and the Durable Medical Equipment MAC Common Electronic Data Interchange (CEDI) contractor to promote ICD-10 Acknowledgement Testing with trading partners during three separate testing weeks, and to collect data about the testing. The first testing week was held November 17-21, and two additional weeks are scheduled:

·         March 2 – 6, 2015

·         June 1 – 5, 2015

While submitters may acknowledgement test ICD-10 claims at any time through implementation, the ICD-10 testing weeks have been created to generate awareness and interest, and to instill confidence in the provider community that CMS and the MACs are ready and prepared for the ICD-10 implementation.

These testing weeks will allow trading partner’s access to MACs and CEDI for testing with real-time help desk support. The event will be conducted virtually and will be posted on the CMS website, the CEDI website and each MAC's website.

Key points of the testing process:

·         Test claims with ICD-10 codes must be submitted with current dates of service since testing does not support future dates of service.

·         Claims will be subject to existing NPI validation edits.

·         MACs and CEDI will be staffed to handle increased call volume during this week.

·         Test claims will receive the 277CA or 999 acknowledgement as appropriate, to confirm that the claim was accepted or rejected by Medicare.

·         Test claims will be subject to all existing EDI front-end edits, including Submitter authentication and NPI validation.

·         Testing will not confirm claim payment or produce a remittance advice.

·         MACs and CEDI will be appropriately staffed to handle increased call volume on their Electronic Data Interchange (EDI) help desk numbers, especially during the hours of 9:00 a.m. to 4:00 p.m. local MAC time, during this week.

·         Your MAC will announce and promote these testing weeks via their listserv messages and their website

MACs and CEDI will be appropriately staffed to handle increased call volume on their Electronic Data Interchange (EDI) help desk numbers, especially during the hours of 9:00 a.m. to 4:00 p.m. local MAC time, during these testing weeks. For more information about acknowledgement testing, refer to the information on your MAC’s website.

End-to-End Testing

During 2015, CMS plans to offer three separate end-to-end testing opportunities. Each opportunity will be open to a limited number of providers that volunteer for this testing. As planned, approximately 2,550 volunteer submitters will have the opportunity to participate over the course of the three testing periods. End-to-end testing includes the submission of test claims to Medicare with ICD-10 codes and the provider’s receipt of a Remittance Advice (RA) that explains the adjudication of the claims.

CMS plans to conduct end-to-end testing with Medicare fee-for-service providers and industry stakeholders in January, April, and July 2015. Registration for the January testing has closed, but opportunities will be available to register for the testing in April and July. The goal of this testing is to demonstrate that:

·         Providers and submitters are able to successfully submit claims containing ICD-10 codes to the Medicare claims systems.

·         CMS software changes made to support ICD-10 result in appropriately adjudicated claims.

·         Accurate Remittance Advices are produced.

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