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ICD-10 Testing: Know Where to Begin


Early ICD-10 testing will allow your medical practice to identify and resolve issues before they disrupt your claims process.

The concept of testing with ICD-10 can be confusing. Knowing where to begin can be a challenge. Make a testing plan now as significant time and resources will be required to complete your testing.

According to the AMA, completing both internal and external testing will take time. Your practice should allow 2 months to 3 months for internal testing and 6 months to 9 months for external testing.

Provider practices will want to test with many entities such as payers, practice management systems, billing companies, and clearinghouses. There are many types of testing such as quality assurance, user acceptance, integration, regression, performance and end-to-end.

Internal testing involves testing your internal systems, business processes, and operational work flow. Internal testing is an important step as it allows your organization take an in-depth look at the systems, work flow and processes and resolve any issues before the compliance date. By resolving the issues early you can mitigate issues such as cash flow.

External testing includes testing with all of your external business partners and involves both sending and receiving transactions. External business partners include payers, clearinghouses, and any third-party billing services. By testing early with your external business partners you will be able to identify issues and resolve them now to avoid disruption to your claims process.

Knowing which business partners to test with and when can also be confusing. In an ideal world, you should test with all of your business partners. However, depending on the amount of business partners you have, it may be impractical to test with all of them.

Prioritize your business partners when making your testing plan. Start with the business partners that make up the largest percentage of practice revenue. Providers may use the Pareto Principle, commonly referred to as the 80-20 rule. In this case it would be applied as 80 percent of your practice revenue is derived from 20 percent of your business partners. For example, you will want to test with your largest payers and your clearinghouses.

Completing your external testing means that you have completed your "end-to-end" testing with your business partners and are ready to "go live." However, the regulation does not allow the use of the ICD-10 code set before the compliance deadline.

Many organizations have free resources available to assist provider practices with the implementation of ICD-10.

The National Government Services (NGS), under contract to CMS offers listening sessions. These sessions provide an update on the current plans toward the transition and offer a forum for feedback.

CMS has additional free resources such as an ICD-10 transition checklist and end-to-end testing checklist for payers and provider. These checklists include estimated timeframes for each task and give practices a guide of tasks to be completed.

Testing is essential to ensure that provider practices are ready for October 1, 2014. Being ready will minimize the negative impacts after implementation. The time to begin is now as testing will take significant time and resources. Begin discussion with vendors, payers, and clearinghouse as soon as possible to be included in their testing schedules.

Jackie Stack, BSHA, CPC, CPC-I, CEMC, CFPC, CIMC, CPEDC, CCP-P, is an ICD-10 specialist for the AAPC . Prior to joining the AAPC, she worked at a large, multi-physician family care and occupational practice with two locations in northwestern Pennsylvania. E-mail her here.

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