WEDI releases tips for small practice ICD-10 testing

Although ICD-10 testing is not required, it is highly encouraged by the Centers for Medicare and Medicaid Services. Testing gives providers a clearer understanding of how ICD-10 implementation could impact the processing of their claims.

These tests also greatly decrease the risk of unanticipated claims issues come October. However, there are only a few testing weeks left, so practices should contact the CMS and Medicare Administrative Contractors to register. 

How can small practices overcome testing challenges?
Practices with one to five physicians are likely to find ICD-10 testing more challenging than larger practices. With this in mind, the Workgroup for Electronic Data Interchange recently published a guide for small practices hoping to participate in successful ICD-10 testing. The white paper focuses primarily on external testing with payers. This form of testing is important, as payers will start to use ICD-10 codes to determine payment decisions and coverage. Practices that take part in external testing will confirm that, once they switch from ICD-9, their claims will be processed without any issues. 

Some of the difficulties that small physician practices may face are a lack of testing opportunities with payers as a result of the small number of testing openings and limited provider resources available to help practices with ICD-10 testing. There are some payers that have established online, self-service tests designed specifically for smaller practices. It is a good idea to find additional resources through these payer ICD-10 websites. The publication also noted that practices may find insufficient ICD-10 training at the disposal of staff.

To benefit from testing and overcome the possible difficulties highlighted in the paper, there are a few initial steps that practices must take. One of the first steps is confirming with their electronic health record vendors that all of the system's applications and software are compliant with ICD-10 standards. The next step is for practices to determine which payers process the majority of their claims and to test ICD-10 readiness with them specifically. It is essential that the specific aspects that a practice needs to test should line up with what the payers plan on testing. 

Helpful tips to complete the testing process
The white paper listed risks that the ICD-10 testing could eliminate, such as the disruption of cash flow, the inability of EHRs to produce ICD-10 claims and delays or denials in claims due to coding errors. 

According to the WEDI's tips, the earlier before the ICD-10 implementation date that practices participate in testing, the better. Prior to beginning the testing process, providers should make sure that everything from the required resources to their teams and the payers and partners involved in testing are prepared. Once practices confirm that they are ready, they should refer to the instructions sent by the billing service or payer.

A calendar or estimated timeline for ICD-10 preparations would help the process run smoother. Then practices must contact clearinghouses to see which dates are available. The upcoming dates for end-to-end testing by the CMS are April 27 through May 1 and July 20 through July 24. The deadline to register for the July testing is coming up on March 13. 

There should be a thorough review of the results with all members of the staff when the testing period is complete. Practices must compare the results with the predicted data for a clear understanding of their success. Any errors that physicians do not understand should be highlighted and discussed with payers to prevent the same issues from resurfacing after the transition. 

Small practices that take advantage of ICD-10 resources and testing opportunities should follow these tips to greatly decrease their risks of running into problems while implementing ICD-10 coding changes.