CMS Says Now is Time to Prepare for ICD-10

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With 328 days left until the ICD-10 compliance deadline of October 1, 2015, now is the time to get ready for the code switchover, according to the Centers for Medicare and Medicaid Services.

“Many of you may think ‘Well, I have another year to go,’” said Denesecia Green of CMS’ Administrative Simplification Group during a Nov. 5 Medicare Learning Network webinar. But, time is of the essence, Green said, adding, “pre-work is the important piece in getting your organization ready for ICD-10.”

Stacey Shagena with the CMS Medicare Contractor Management Group told the virtual audience that end-to-end testing with Medicare Administrative Contractors, the Railroad Retirement Board, and the Common Electronic Data Interchange contractor is slated for January, April and July 2015, which providers should take advantage of. About 850 providers will have the opportunity to participate during each testing period, said Shagena.

The purpose of the testing is to demonstrate that healthcare organizations are able to successfully submit ICD–10 claims to shared systems and that software changes made to support ICD–10 result in appropriately adjudicated claims. Test claims submitted will be processed and remittance advice will be generated.

Week-long ICD-10 acknowledgement testing—November 17 through 21, 2014; March 2 through 6, 2015; and June 1 through 5, 2015—is also scheduled to allow providers, suppliers, billing companies and clearinghouses the opportunity to determine whether CMS will be able to accept their claims with the new codes. In addition, providers, suppliers, billing companies and clearinghouses are welcome to submit acknowledgement test claims anytime up to the October 1, 2015 implementation date.

However, results of a recent ICD-10 survey, conducted by the American Health Information Management Association and eHealth Initiative, found that smaller healthcare organizations—such as physician practices—are not prepared for the ICD-10 transition and are not equipped for such testing.

To address this problem, Green said CMS has developed a “Small Physician Practice Catch-up Plan” for ICD-10 with specific milestones for training, updating processes, engaging vendors and payers, as well as testing systems and processes. “If you are among the physicians that are falling behind, there are opportunities to catch up,” she said.

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