Electronic Health Records

Policy & Regulation News

CMS Finds ICD-10 Testing Successful

By Vera Gruessner

- Marilyn Tavenner, Administrator at the Centers for Medicare & Medicaid Services (CMS), announced today that the organization recently finished the first week of end-to-end testing for ICD-10 coding.

The ICD-10 testing week took place between January 26 to February 3 and included Medicare Fee-for-Service providers, billing sites, and clearinghouses. All in all, it was a successful week of testing, poising the US healthcare industry at an advantage when transitioning to ICD-10 coding in the near future.

While ICD-10 integration has taken place in most other countries, the United States has yet to incorporate ICD-10 compliance in its healthcare industry. Tavenner goes on to explain that ICD-10 codes provide much more accuracy and specificity for physicians, which means data capture is greater and doctors would be able to learn more about the conditions afflicting their patients. The current ICD-9 coding is more than 35 years old and does not have the same room to expand diagnostic codes as ICD-10.

The current deadline for implementing ICD-10 coding in the United States is October 1, 2015. The end-to-end ICD-10 testing results stem from approximately 15,000 test claims submitted by 660 healthcare providers. Out of all these test claims, 81 percent were accepted.

CMS provides this ICD-10 testing program in order to ensure the nation’s providers will be able to effectively file Medicare claims through their billing systems once the US healthcare industry transitions to the new coding system.

The results from the end-to-end ICD-10 testing show that the majority of participants were capable of successfully submitting ICD-10 claims to be processed by CMS. The results were favorable, as most of the claims that did not go through were not due to ICD-9 or ICD-10 errors. Only 6 percent were due to ICD-9 or ICD-10 mistakes while 13 percent were due to unrelated missteps.

Tavenner does mention one source of confusion in the healthcare community. ICD-9 is to be used for services before the October 1 deadline while ICD-10 will become the standard starting on and after October 1, 2015. At this moment in time, ICD-10 will only be used for testing. Additionally, ICD-9 cannot be used in a physician’s practice including billing processes after October 1.

ICD-10 integration is a requirement for all healthcare providers and not only those accepting Medicare or Medicaid. As such, medical coverage programs around the nation are conducting ICD-10 testing with a multitude of physicians, hospitals, and other healthcare facilities.

Tavenner goes on to say that no major issues were found from the end-to-end testing and encourages other providers to take part in testing their ICD-10 preparedness before the deadline. Two more end-to-end testing sessions are expected to take place during the weeks of April 27 through May 1 and July 20 through July 24.

“I appreciate the tremendous efforts and achievements of health professionals as we work together to realize the benefits of ICD-10 and other advances toward the ultimate goal of improving the quality and affordability of health care for all Americans,” Tavenner concluded.