End-to-End Testing: Don’t Let ICD-10 Implementation Glitches Catch You by Surprise

End-to-End Testing: Don’t Let ICD-10 Implementation Glitches Catch You by Surprise

If you haven’t engaged in acknowledgement testing (also known as end-to-end testing) for ICD-10 preparedness, you ought to get moving! Testing gives the involved health providers, clearinghouses, and payers an opportunity to correct claims’ deficiencies prior to the October 1, 2015 “go live” date.

Early acknowledgement testing results have been positive, and suggest that misgivings about ICD-10 implementation have been exaggerated. For example, of the over 2000 respondents in a recent AAPC survey, 84 percent of those who had taken part in acknowledgement testing considered it to be a success. Seventy-two percent of respondents saw no claims denied during testing. An additional 16 percent experienced a rejection rate of less than 10 percent. Over 90 percent of respondents said they noticed no payment shift on test claims.

The survey responses are in line with CMS results. For instance, during a recent (November 2014) testing period, CMS processed 13,700 claims from more than 500 providers, suppliers, billing companies, and clearinghouses. CMS revealed, “Testing did not identify any issues with the Medicare FFS claims systems.” Overall, CMS accepted 76 percent of total test claims. Acceptance rates improved throughout the week; by Friday the acceptance rate for test claims was 87 percent.

The most common errors encountered during had nothing to do with ICD-10, CMS said. “The majority of rejections on professional claims were common rejects related to an invalid NPI. Some claims were rejected because they were submitted with future dates. Acknowledgement testing cannot accept claims for future dates.”

The bad news about the upcoming ICD-10 transition is that too few health providers have taken the final step to ensure that the transition is seamless. For example, only 17 percent of respondents in the AAPC survey said they have taken part in acknowldegement testing to assess ICD-10 readiness. Over half (56 percent) said they were not offered testing.

If you haven’t performed acknowledgement testing with all your important payers, don’t wait for them to contact you. Reach out to your payers and ask them if the offer end-to-end testing, and take part. Lessons learned during testing may be vital to a successful transition. Better to confirm your ICD-10 readiness, now, than to face cash flow problems due to a backlog of unprocessed claims, come October.

Testing tip: The Centers for Medicare & Medicaid Services (CMS) will conduct limited end-to-end testing April 27-May 1, 2015 and July 20-24, 2015.

Sample ICD-10 Testing Survey

2000+ individuals respond to the ICD-10 testing survey

dec-clearance-sale

  1. Was testing offered to your practice? Of those who responded:
    1. 56% said they were not offered testing
    2. 17% said they were and participated
    3. 6% were offered testing but chose to decline
  2. Who did you test with?
    1. CMS 20%
    2. Medicaid 10%
    3. Humana 7%
    4. United Health 5.8
    5. Blues 10%
    6. Aetna 6%
    7. Other 30%
  3. Did you notice a payment shift on test claims? Those who tested indicated:
    1. 92% No
    2. 8% Yes
  4. How much have you spent on ICD-10 implementation per provider?
    1. Less than $5,000 72%
    2. $5001-$10,000 26%
    3. Other 2%
  5. If you tested, did you consider your results successful?
    1. 84% Yes
    2. 16% No
  6. What percentage of your claims denied during testing?
    1. < 10% 16%
    2. 20-40% 6%
    3. > 50% 3%
    4. All 3%
    5. None 72%

 

John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 404 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

Leave a Reply

Your email address will not be published. Required fields are marked *