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Testing, Testing ... Is This ICD-10 Transition On?

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A January 16, 2013 blog by Carl Natale from ICD10 Watch condensed the lefts for Medicare and Medicaid Services (CMS) tips on the ICD-10 transition. His blog lists two CMS milestones and summarizes CMS guidelines on what to test and how to implement ICD-10. His blog follows:

 

April 1, 2013

Start testing ICD-10 codes and systems with your coding, billing, and clinical staff. CMS suggests:

 

 "Use ICD-10 codes for diagnoses your practice sees most often"

 "Test data and reports for accuracy"

 

In addition to testing the data and how the systems work, you need to test how ICD-10 will affect reimbursements. In a nutshell, will the transition from ICD-9 codes to ICD-10 codes be revenue neutral?

 

October 1, 2013

This was the milestone formerly know as the drop-dead deadline written in stone for ICD-10 implementation. Now it's just a suggested starting point for testing with trading partners. Develop a testing plan that:

 

 Identifies the high-risk trading partners

  1. o  Healthcare payers

    o  Clearinghouses

    o  Billing services

 Establishes guidelines for what gets tested

 Creates ongoing communication with trading partners

 Collaborates with trading partners to create testing scenarios

 Creates a process that resolves issues before and after the deadline.

 

Until the Oct. 1, 2014, deadline, continue testing and adjusting your ICD-10 transition.

 

What to test

Just the high-risk ICD-9 codes. Those are the ICD-9 codes that can be replaced by many ICD-10 codes. Convert those medical codes and use them in test claims. Create multiple medical claims for each ICD-10 code. Change variables in each test file.

 

How to get there

CMS also lays out some steps for getting there:

 

 "Review ICD-10 resources from CMS, trade associations, payers, and vendors"

 "Inform your staff/colleagues of upcoming changes"

 "Create an ICD-10 project management team"

 "Identify how ICD-10 will affect your practice"

 "Develop and complete an ICD-10 project plan for your organization"

o  "Identify each task, including deadline and who is responsible"

o  "Develop plan for communicating with staff and business partners about ICD-10"

 "Estimate and secure budget (potential costs include updates to practice management systems, new coding guides and superbills, staff training)"

 "Ask your payers and vendors—software/systems, clearinghouses, billing services—about ICD-10 readiness; review contracts/proposals"

o  "Ask about systems changes, a timeline, costs, and testing plans"

o  "Ask when they will start testing, how long they will need, and how you and other clients will be involved"

o  "Select/retain vendor(s)"

 "Review changes in clinical documentation requirements and educate staff by reviewing frequently used ICD-9 codes and new ICD-10 codes"

 

There's a more detailed - you can say more granular – ICD-10 transition timeline available.

 

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