ICD-10: LTC must get ready

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CMS Administrator and Secretary of the Medicare Trustees Marilyn Tavenner
CMS Administrator and Secretary of the Medicare Trustees Marilyn Tavenner

The procrastination is over for the conversion to ICD-10 coding. After the third postponement of the start date last year, officials are adamant about starting the new format Oct. 1.

“Let's face it, guys, we've delayed this several times and it's time to move on,” Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner told attendees at the Healthcare Information and Management Systems Society convention in February. 

So ready or not, healthcare providers — and that includes long-term care — need to have the infrastructure and resources in place to start billing Medicare in the new highly stratified coding format. While the conversion poses major upheaval for large acute care health systems that have not yet positioned themselves for the switch, much smaller long-term care providers still have time to adjust, says Bobbi Brown, vice president of financial engagement for Health Catalyst.

“Since it is still several months away, that should be enough time for smaller providers,” she said.

To help billers get ready, CMS has been offering acknowledgement testing dates in which ICD-10 claims can be sent to the agency for acceptance. These tests are likely to continue through the spring and summer, according to a recent CMS memo.

The testing concept was originally designed to validate contractors' ability to meet technical compliance and performance processing standards during the HIPAA 5010 implementation. 

CMS also plans to offer end-to-end testing this summer. This will involve submission of test claims and generation of remittance advice to ensure that proper claims adjudication is occurring. A “small sample group of providers” will be involved, representing a cross-section of provider types. 

CMS is offering beta testing tools for providers, and the memo provides links to many of them. If testing shows that a provider will not be able to submit ICD-10 claims via its own system by the deadline, CMS suggests using free billing software offered through Medicare administrative contractors.

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