CMS announces success of recent ICD-10 testing

The Centers for Medicare & Medicaid Services officially completed the first week of end-to-end ICD-10 testing. Marilyn Tavenner, administrator at the CMS, reported that the results were very encouraging, highlighting the fact that the health care industry is finally ready to move forward with coding procedures. This final testing period occurred between Jan. 26 and Feb. 3 and included clearinghouses, Medicare Fee-for-Service providers and billing sites.

End-to-end testing proves successful
ICD-10 testing periods are offered by the CMS to prepare physicians as the industry switches to the new coding system on Oct. 1, 2015. It is key that providers are able to file Medicare claims without running into problems with their billing systems. 

Implemented in the 1970s, ICD-9 no longer contains an acceptable set of codes for doctors who prioritize quality patient care. In fact, The U.S. is one of the only countries in the world that has not implemented the new set of codes. 

Tavenner explained that the industry's readiness for the transition is important because the new codes offer more accuracy and efficiency when diagnosing patients. According to EHR Intelligence, this ultimately enhances data capture and allows doctors to gain a firmer grasp on the conditions that are impacting their patients. 

The first round of testing included almost 15,000 test claims submitted by 660 health care providers. Of these, the statistics recently released by the CMS showed that the agency accepted 81 percent – a number much higher than many experts expected. These results show that the health care industry will be at an advantage when the time comes for providers and hospitals to make the switch from ICD-9 to ICD-10 in October. 

The fact that most of the providers who participated in the testing are now able to have their claims successfully processed by the CMS eliminates any chances that the ICD-10 implementation date will be postponed due to the industry's lack of preparedness. The report by the CMS explained that only 6 percent of the participants whose claims did not go through had overlooked ICD-9 or ICD-10 errors. The final 13 percent of failed claims were due to unrelated mistakes.

Uncertainty over implementation date 
Although the final testing yielded promising results, it also shed light on some confusion among providers regarding the implementation date of ICD-10. Tavenner explained that ICD-9 is for services provided before the Oct. 1 deadline, and that ICD-10 is for services provided after Oct. 1, 2015.

"That means ICD-10 can be used only for test purposes before Oct. 1. And only ICD-10 can be used for doctor's visits and other services that happen on or after Oct. 1," Tavenner said in the announcement. "ICD-9 cannot be used to bill for services provided on or after Oct. 1. This rule applies no matter when the claim is submitted, so claims submitted after October 2015 for services provided before that date must use ICD-9 codes."

Some providers were also under the impression that the ICD-10 transition was mandatory only for those receiving Medicare or Medicaid instead of the entire industry. However, despite the slight confusion, there were no significant problems that resulted from the testing.

There are two more testing periods coming up in April and July. Tavenner highly encouraged providers who have not participated in testing to begin preparing for Oct. 1, whether it is participating in one of the upcoming tests or relying on educational resources to train staff members. 

Tavenner ended the announcement by congratulating the health professionals who participated in the testing and emphasized how important it is that the health care industry makes a conjoined effort to advance toward the goal of enhancing care quality for patients throughout the nation.