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May 30, 2013

Will Providers Be Able to Test ICD-10 Claims with Their Contractor in Advance of the October 1, 2014, Implementation Date?

Medicare does not plan to pursue testing of Medicare fee-for-service (FFS) claims directly with providers for ICD-10 at this time. The Centers for Medicare & Medicaid Services (CMS) feels confident that the current level of testing that is done each quarter for any changes to the Medicare claims processing systems is effective to ensure that claims will be processed properly and that ICD-10 diagnosis codes will be accepted and claims will be processed correctly.

CMS follows a very rigorous system development life cycle in which the changes to the Medicare FFS systems are tested. When changes are developed, the following protocol is used:

  • The maintainers conduct alpha testing for one month
  • The single testing contractor conducts beta testing for two months
  • Part A and Part B Medicare Administrative Contractors (A/B MACs) conduct user acceptance testing for one month

In addition, because most ICD-10 system changes are expected to be completed by October 1, 2013, a full year ahead of schedule, CMS plans to conduct additional testing prior to the October 1, 2014, implementation date.

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