ICD-10 Readiness Testing: What, Who, and When

May 4, 2015
Avery Hurt

Reduce the number of unpleasant surprises when the ICD-10 coding system goes live in October by starting tests now.

According to an ICD-10 industry readiness survey released last month by the Workgroup for Electronic Data Interchange (WEDI), only 25 percent of the providers surveyed had begun external testing with partners on ICD-10 claims.

Conducting your own testing is not essential, but it is prudent. And if you do it right, it might be less of an ordeal than you think.

What to Test:

You can't test everything. So how do you know what to test?

"It's best to take a risk-based approach," said Thomas Parnon, director of healthcare business development at software testing company QualiTest group. "Start with the codes that have the highest risk and potential impact for your practice and work your way down."

Most larger practices have run analytics so they know their most frequently used codes, the ones that make them the most money, and the ones most likely to be denied or queried. Your software may have a filter that will give you this information with a few clicks. If you don't know how to find it, ask your vendor.

Some consulting firms offer this service as well, said Parnon. It's worth a little time and effort to be able to focus your testing. The time saved not testing codes that aren't likely to cause you problems will more than make up for the time spent finding out which ones you should test.

Who to Test With:

Try to arrange testing with everyone you use codes when communicating with: payers, clearinghouses, partners (such as labs, other clinics, hospitals, etc.). Make sure their software is upgraded as well.

"The biggest challenge of testing with payers is getting them to work with you on testing and scheduling time for testing, though many of the big payers are working hard to accommodate people who need to test," said Parnon.

When to Test:

When testing, the sooner, the better. Testing is definitely something you don't want to do at the last minute, and there's not much time left. And remember, your partners are just as busy as you are, so scheduling a testing period for both parties might be tricky.

Testing now could save you headaches - and maybe money - later, but there's no reason to panic if you can't do as much testing as you'd like.

"If on Oct. 1 you've not yet tested, you'll find out soon enough where your problems are. More testing is always better - but money isn't falling out of trees," said Parnon. "The world is not going to end on Oct. 1 if you haven't tested everything. You just have to do the best you can and be prepared to deal with the inevitable bumps."

If you've prepared for cash-flow problems, it will be much easier to deal with the bumps that might occur because you didn't do enough testing. But if you can manage to do some careful, targeted testing, you'll be glad you did.