GE Healthcare’s Centricity EDI Services (C-EDI), CIPROMS’ claims clearinghouse, recently was selected by several Medicare Administrative Contractors (MACs) to perform true end-to-end testing for ICD-10 claim submission during the first round of testing January 26-30, 2015. This testing will include full adjudication of claims for 50 submitters within each MAC’s system, along with returning a test ERA (remit file) for users to see how Medicare would have adjudicated the claim if it were a true claim.
C-EDI, in turn, has selected several of its users, including CIPROMS, to submit files. CIPROMS will submit one file of five patients, 2 providers, and 25 claims each for three of the MACs: Indiana Medicare (WPS), Ohio Medicare (CGS Admin), and Georgia Medicare (Cahaba). C-EDI is limited to 50 total test claims in no more than 3 files for no more than 5 provider identification numbers for each MAC.
CIPROMS will use the opportunity of end-to-end testing to submit claims across all of our major specialties of billing among the three MACs. Test claims will be future dated to October 1-15, 2015, and will contain ICD-10 codes chosen by certified coders.
According to the Centers for Medicare and Medicaid Services (CMS), three end-to-end testing periods are planned in 2015 in January, April, and July. Over those three weeks, approximately 2,550 volunteer submitters will have the opportunity to participate. The goals of this testing are to demonstrate that:
- providers and submitters are able to 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, and
- accurate remittance advices are produced.
CIPROMS successfully participated in earlier Limited End-to-End ICD-10 Testing through C-EDI and five MACs in March 2014 and volunteered with C-EDI to participate in any future testing.
For more information about other ICD-10 testing opportunities with Medicare, review CMS’s ICD-10 Testing Opportunities for Medicare FFS Providers release from August 2014.
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