"This is only a test" is one of those phrases meant to put people at ease. But when it comes to ICD-10 testing, maybe healthcare providers shouldn't be at ease.
Provider organizations should approach ICD-10 testing with a sense of urgency. This is when they will learn what they don't know and how ICD-10 codes will affect them after Oct. 1.
During the National Pilot Program, healthcare providers gained insights into productivity and accuracy. Some of those insights were scary, but that's okay. That test was more than a year away from the implementation date. There's still time to get up to speed.
Nevertheless, it's disheartening to read that medical coders forgot to complete claims, scanned test documents upside down and confused numbers and letters. It feels like time is wasted correcting basic mistakes.
The only positive takeaway is that medical coders need to be more careful. But we don't need a nationally coordinated effort to figure that out.
It seems to me the best way to get the most out ICD-10 testing is to practice. Learn how to tell the difference between an "O" and "0". Practice scanning documents. Develop some proficiency. Then you will learn:
- How much medical coding productivity can be expected.
- Will accuracy be a problem with medical coders familiar with ICD-10 codes?
- What systems use ICD codes.
- How much reimbursements can change.
- Where documentation needs to improve.
Some best practices can help:
- Documentation: Include the clinical documentation that supports your test ICD-10 codes. This is more than medical notes; necessary information may be found in lab reports and other test results.
- Real medical records: Test the types of cases you actually will be treating and submitting for reimbursement. This is the best way to judge the impact of ICD-10 implementation on a practice. Don't just test scenarios that match healthcare payers' mappings.
- Dual coding: This can be expensive and time consuming, but it will expose any problems with new equipment and systems, create test data that can be used and give your staff valuable practice.
- Testing plan: Create a comprehensive ICD-10 testing plan that identifies scenarios, trading partners, test data and goals.
- Quality assurance: The plan needs to track internal testing, testing of transactions with multiple trading partners, the testing schedule and testing results.
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Trading partners: Develop testing plans with mission critical vendors and payers that include:
- Contacts who can answer questions and a communication process to work through issues;
- Schedules;
- Number of test files that can be sent for each transaction (Multiple test files for each transaction allows any errors encountered to be resolved and verify they are corrected);
- A copy of the partner's test plan.
Before you begin testing, you should "study:"
- Identify testing workflows and scenarios for your practice that apply use cases, test cases, test reports, and test data.
- Identify when your practice will be able to run test claims using ICD-10.
- Develop a project plan that recognizes dependencies on tasks and resources. The plan should prioritize and sequence efforts to support critical paths.
If there is an ICD-10 code for sweating the small stuff, testing is not a time to use it.