ICD-10 Compliance Step 5

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.

This week CMS is highlighting 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, and 5) Test Your Systems and Processes. The focus of this article 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.

Keep Up to Date on ICD-10
Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow CMS.gov on Twitter.