CMS to Conduct Limited End-to-End ICD-10 Testing

Bowing to intense industry pressure, the Centers for Medicare and Medicaid Services has announced it will conduct “limited” end-to-end testing of ICD-10 during the summer of 2014.


Bowing to intense industry pressure, the Centers for Medicare and Medicaid Services has announced it will conduct “limited” end-to-end testing of ICD-10 during the summer of 2014.

The agency has been stubbornly clinging to a previously announced March 3-7 ICD-10 “acknowledgement” testing period to enable providers, billers and clearinghouses to determine if CMS contractors can accept their claims as it sole testing period. But CMS has increasingly come under fire from stakeholders--primarily the American Hospital Association, American Medical Association and Medical Group Management Association--to conduct the far more extensive end-to-end testing to assure proper adjudication and payment of claims.

Here is the CMS Feb. 19 announcement of end-to-end testing, which Modern Healthcare first reported:

“In summer 2014, CMS will offer end-to-end testing to a small sample group of providers. Details about the end-to-end testing process will be disseminated at a later date.

“End-to-end testing includes the submission of test claims to CMS with ICD-10 codes and the provider’s receipt of a Remittance Advice (RA) that explains the adjudication of the claims. The goal of this testing is to demonstrate that:

* “Providers or submitters are able to successfully submit claims containing ICD-10 codes to the Medicare FFS claims systems;

* “CMS software changes made to support ICD-10 result in appropriately adjudicated claims (based on the pricing data used for testing purposes); and

* “Accurate RAs are produced.

“The small sample group of providers who participate in end-to-end testing will be selected to represent a broad cross-section of provider types, claims types and submitter types.

“If you have any questions, please contact your MAC at their toll-free number, which may be found at http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Review-Contractor-Directory-Interactive-Map/index.html on the CMS Web site.”

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