CMS Offers ICD-10 Claims Testing for FFS Providers

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  • August 5, 2014
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With the U.S. Department of Health & Human Services’ (HHS) announcement on July 31 of the new ICD-10 compliance date of October 1, 2015, the Centers for Medicare & Medicaid Services (CMS) released ICD-10 testing information for Medicare fee-for-service (FFS) providers. To help ensure CMS and FFS providers will be ICD-10 complaint by the implementation deadline, they have come up with an approach (as outlined in MLN Matters® Number: SE1409 Revised), which includes:

  • CMS internal testing of its claims processing systems – CMS has been installing and testing system changes to support ICD-10 since 2011. As of October 1, 2013, Medicare FFS claims processing systems were ready for ICD-10 implementation, and CMS continues to test for preparedness.
  • Provider-initiated beta testing tools – CMS has a variety of Beta versions of its software that include ICD-10 codes, National Coverage Determination (NCD), and Local Coverage Determination (LCD) code crosswalks to test your system’s readiness. Testing tools include: NCDs and LCDs ICD-10 conversions, The ICD-10 Medicare Severity-Diagnosis Related Groups (MS-DRGs) conversion project, and Integrated Outpatient Code Editor (IOCE) using ICD-10-CM.
  • Acknowledgement testing – Providers, suppliers, billing companies, and can submit test claims any time before October 1, 2015. CMS offers special acknowledgement testing weeks in November, March, and June 2015 where claims submitters will have access to help desk support.
  • End-to-end testing – Medicare FFS providers can volunteer to participate in end-to-end testing with Medicare administrative contractors and the Common Electronic Data Interchange (CEDI) contractor in January, April, and July 2015. Testing goals are to demonstrate successful ICD-10 claims submission to Medicare’s FFS claims systems, CMS software changes supporting, appropriately adjudicated claims and accurate remittance advices.

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CMS also offers claims submission alternatives, such as billing software that only works for submitting FFS claims to Medicare. The software “is intended to provide submitters with an ICD-10 compliant claims submission format; it does not provide coding assistance,” according to MLN Matters® Number: SE1409 Revised.

Michelle Dick
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Michelle A. Dick, BS, is a freelance content specialist, providing writing, editorial expertise, and graphic imagery to clients. Prior to becoming a free agent, she was an executive editor for AAPC, editor-in-chief at Eli Research, and editor at Element K Journals. After earning a Bachelor of Science from the State University of New York at Buffalo State, Dick entered the publishing industry as a graphic artist, ad coordinator, and web designer for White Directory Publishers, Inc.

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