Skip to content Skip to navigation

AHA Urges CMS to Begin ICD-10 Testing by January

November 25, 2013
by Rajiv Leventhal
| Reprints

The American Hospital Association (AHA) is urging the Centers for Medicare & Medicaid Services (CMS) to expedite its ICD-10 testing plans to make sure testing begins no later than January 2014 and that it is made available to all hospitals.

In a letter to CMS sent on November 20, AHA says that while it appreciates the agency’s efforts to offer extensive educational opportunities for providers, extensive, end-to-end testing by Medicare contractors and state Medicaid agencies of both the electronic transaction and the adjudication of the claim will be needed to ensure a smooth transition from ICD-9 to ICD-10.

Hospitals across the country have invested significant financial and human resources in preparing for the transition to ICD-10 that will occur on Oct. 1, 2014. AHA says that its members have said that they are ready, or nearly ready, to start external testing with CMS and others. “Therefore, we were concerned to read recent news articles stating that the agency would not undertake external testing of ICD-10 due to a lack of funding within the agency, according to a CMS official,” wrote Linda Fishman, AHA senior vice president of public policy analysis and development.

As CMS rolls out external testing, AHA asks the agency to allow for and provide the same opportunity for small hospitals to test with its contractors as larger facilities, citing concerns that these providers will be overlooked.

According to AHA, successful testing requires two essential components:

Testing connectivity and the transaction exchange for a claim containing ICD-10 codes. Since the current 5010 transaction standard will be used to transmit the ICD-10 codes, AHA does not expect connectivity problems arising from the claims data exchange. Nevertheless, this testing step still needs to be done to ensure that any changes made to accommodate the ICD-10 codes in the 5010 standard did not create exchange problems. The connectivity test also should include plans for front-end edit testing of the claim to ensure that it can pass an initial review of claim integrity and then move forward to the next level—the claims adjudication process.

Testing the provider’s and payer’s ability to correctly handle the ICD-10 content as part of the claims adjudication process. The test of the claims adjudication process should help providers understand whether there is a match between the anticipated payment and the payment actually assigned by the health plan. This step will allow hospitals to identify and correct any errors in their documentation and coding processes. It will also provide them with needed information to estimate how the transition might affect revenues.

Get the latest information on ICD10 and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

CMS Looks to Increase Patient Engagement with New Models

The Centers for Medicare & and Medicaid Services (CMS) has announced two new models from the CMS Innovation Center (CMMI) that will aim to increase patient engagement in care decisions by putting more information in the hands of Medicare beneficiaries.

Medtronic, Fitbit Integrating Health and Activity Data for Diabetes Management

Fitness wearables company Fitbit, based in San Francisco, and Dublin, Ireland-based Medtronic, a medical device company, have teamed up to integrate health and activity tracking for patients living with diabetes and their physicians and care teams.

UC San Diego Health Offering EHR, iPad Access to Patients

Patients at the recently-opened Jacobs Medical Center at UC San Diego Health can be in more command with their own experience by assessing their own medical information, controlling room features and more.

Texas Medical Center, Australia Form BioBridge to Develop Health Innovation

Houston-based Texas Medical Center (TMC) and the Melbourne-based Health Informatics Society of Australia (HISA) are collaborating on a health startup exchange program.

Teladoc Hits 101K Patient Visits in November

Telehealth vendor Teladoc announced this week that it totaled 101,600 e-health patient visits in November, setting a company record.

Research of mHealth Apps Reveals Significant Gaps in Quality

An evaluation of 137 patient-facing mobile health apps revealed that few apps address the needs of the patients who could benefit the most, according to research in December’s issue of Health Affairs.