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ICD-10 Deadline October 1, 2015: Test Your Systems and Processes

Get Ready Now with the New CMS Quick Start Guide!

While ICD-10 is almost here, you still have time to get ready. But you must get ready now.

Each day this week we are highlighting 1 of the 5 steps from the new Quick Start Guide:

  1. Make a Plan
  2. Train Your Staff
  3. Update Your Processes
  4. Talk with Your Vendors and Health Plans
  5. and Test Your Systems and Processes. Today our focus is

Step: 5 Test Your Systems and Processes

  • Verify that you can use your ICD-10-ready systems to:
    • Generate a claim
    • Perform eligibility and benefits verification
    • Schedule an office visit
    • Schedule an outpatient procedure
    • Prepare to submit quality data
    • Update a patient’s history and problems
    • Code a patient encounter
  • Test your systems with partners like vendors, clearinghouses, billing services, and health plans; focus on those partners that you work with most often
    • Medicare providers can conduct acknowledgement testing with their Medicare Administrative Contractors (MACs) until the October 1 compliance date
  • Explore alternate ways to submit claims to health plans if you think your systems will not be ready for ICD-10 by Oct 1:
    • For Medicare providers, options include:
      • Free billing software available from every MAC website
      • Part B claims submission by online provider portal (in about ½ of MAC jurisdictions)
      • Paper claims for providers who meet Administrative Simplification Compliance Act Waiver requirements
      • Each of these options requires you to code in ICD-10
    • Ask other health plans you work with about the options they offer

Tips

  • Your clearinghouses and billing services can conduct Medicare acknowledgement testing on your behalf
  • Many major health plans report that they have portals or other options in place for providers who cannot submit ICD-10 claims electronically
  • If you think you might need to use an alternate claims submission method for Medicare, get started now
    • Allow time for you and your staff to complete free training on billing software or portals before October 1
    • You must register for each MAC portal that you use
  • If you are eligible to submit paper claims for Medicare and wish to do so, order CMS 1500 forms from the Government Publishing Office or your office supply store
    • Photocopies cannot be used because they cannot be scanned correctly

To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals.

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