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ICD-10: CMS Agrees to Limited End-to-End Testing

John Commins, for HealthLeaders Media, February 20, 2014

Following concerns from physicians and some US senators, CMS says it will do end-to-end ICD-10 testing with a small sample group of providers selected to represent "a broad cross-section of provider types, claims types, and submitter types."

In an apparent nod to concerns raised by physicians, payers, hospitals and Congress, the federal government said Wednesday that it would conduct limited "end-to-end testing" of the new ICD-10 diagnostic coding set this summer with "a small sample group of providers."

"End-to-end testing includes the submission of test claims to [the Centers for Medicare & Medicaid Services] with ICD-10 codes and the provider's receipt of a Remittance Advice (RA) that explains the adjudication of the claims. The small sample group of providers who participate in end-to-end testing will be selected to represent a broad cross-section of provider types, claims types, and submitter types," CMS said in a memo to providers.

The goal of the end-to-end testing is to demonstrate that:

  • Providers can successfully submit claims containing ICD-10 codes to the Medicare FFS claims systems.
  • CMS software changes made to support ICD-10 result in appropriately adjudicated claims based on the pricing data used for testing purposes.
  • Accurate Remittance Advices are produced.

Details about the end-to-end testing process will be disseminated "at a later date," CMS said.

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