End-to-End ICD-10 Testing: Are You Prepared?

March 3, 2014
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end to end testingAccording to a recent survey, less than 10% of physician practices are ready for the upcoming transition to International Classification of Diseases, 10th Edition (ICD-10), up from less than 5% a half year prior.

end to end testingAccording to a recent survey, less than 10% of physician practices are ready for the upcoming transition to International Classification of Diseases, 10th Edition (ICD-10), up from less than 5% a half year prior.  Will you be ready for the October 2014 changeover deadline or will this be HealthCare.gov all over again?

What are we supposed to be preparing ourselves for?

A similar survey to the one showing this lack of readiness in doctor offices across the country indicates less than 75% of respondents say they’ve begun implementing their ICD-10 transition plan. [FierceHealthIT] So this won’t turn into another healthcare website roll-out fiasco, just what should your transition plan focus on?

At the Healthcare Information and Management Systems Society’s annual meeting in New Orleans last March, Marc Probst, Intermountain Healthcare, was told by one of the attendees that he thought ICD-10 would be particularly grueling, 

“ICD-10 is massive.  It’s a lot of effort and a lot of risk.”

Any hospital chief information officer (CIO) will tell you, the transition to ICD-10 is at the top of his list of most challenging 2014 initiatives.  The mandatory switch from ICD-9 that goes into effect October 1 of this year might be rough, especially as it overlaps with other such mandates (like Meaningful Use).

U.S. senators share this view and made their concerns clear to Marilyn Tavenner, Administrator of the Centers for Medicare & Medicaid Services (CMS) at the Department of Health and Human Services stating:

“The significance of this transition can hardly be overstated.  The economic impact of the ICD-10 transition on insurers and medical providers will be billions of dollars. … Before either Medicare or Medicaid could conceivably transition to any new diagnostic coding method, CMS must establish clear metrics and perform system-wide tests to certify its readiness.” [FierceHealthIT]

Senators Tom Coburn (R-OK), John Barrasso (R-WY), John Boozman (R-AR), and Rand Paul (R-KY), in questioning the previous HHS plan to perform only front-end ICD-10 testing, put their finger on the main problem with the ACA release: lack of sufficient testing throughout. 

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GOOD NEWS: Testing will start early and be thorough . .

MGMA President and CEO Susan Turney stated in a letter to HHS Secretary Kathleen Sebelius that failure to test properly “could result in significant cash flow disruption for physicians and their practices, and serious access to care issues for Medicare patients.” [FierceHealthIT] They got the message.  The CMS has instituted a four-pronged approach to preparedness and testing to make sure they and the Medicare Fee-For-Service (FFS) provider community are in gear.  This plan includes: [CMS.gov]

  • Provider-initiated beta testing tools.
  • Acknowledgement testing.
  • End-to-end testing for a “small sample group of providers”. 

Each quarterly release supported by the Medicare FFS claims processing systems is in turn supported by a three-tiered and time-sensitive testing methodology that comprises: 

  • 4-week alpha testing by FFS claims processing system maintainers.
  • 8-weeks beta testing by an integration contractor.
  • 4-week acceptance testing by each MAC.

All this is good news for your efforts to get your medical practice ready for the switch, but how will your group get ready for the testing? 

Image courtesy of: nokhoog_buchachon/ Freedigitalphotos.net