• ICD-10 Prep Ramps Up with Testing Week, New CMS 1500 Form

    ICD-10 is coming — there is no delay. Your time to prepare for the biggest change to coding in 30 years is now. All practices must be ready to transmit ICD-10 codes on Oct. 1; beginning that date, all ICD-9 codes will be rejected.

    To help practices prepare for the change, CMS and Medicare administrative contractors will host an ICD-10 test week from March 3 to 7. Any physician who submits claims via certified electronic data interchange (CEDI) can participate. Practices that bill on paper cannot take part in the testing week.

    You have to register in advance to take advantage of the testing week. Spaces are limited, since all of medicine can register to participate. Registration info is listed in order of jurisdiction on the American Academy of Ophthalmic Executives website. Be sure to get your practice on the list with your MAC carrier immediately.

    Why should testing week matter to you? With any implementation of a new system, testing helps ensure a smooth transition. The March testing week provides a chance for CMS and CEDI vendors to identify and correct any problems with the new claims-submission format.

    Have you already asked your CEDI and EHR vendors if they are ICD-10 compliant? Now is the time to check. If they are not, find out when they plan to be. You also need to know if there are any scheduled updates that require you to sign up. View AAOE’s ICD-10 checklist to see what else your practice needs to do to prepare.

    What can you expect during testing week? As posted on every carrier website, here are some things to remember:

    • Test ICD-10 claims must be submitted with current dates of service (i.e., Oct. 1, 2013, through March 3, 2014); testing does not support future-dated claims.
    • Tests must be sent with the ISA15 containing a “T.”
    • Send no more than 25 claims per file; multiple files per day are allowed.
    • Results will be emailed to the address provided in registration information.
    • Test claims will receive the 999 or 277CA acknowledgement, as appropriate, to confirm whether the claim was accepted or rejected in the system. Test files rejecting for an ICD-10 error will not be considered a passed test.
    • Testing will not confirm claim payment or produce remittance advice.
    • Test submitters must be a current production submitter.
    • MACs and CEDI will be staffed to handle increased call volume during this week.

    To stay up to date on ICD-10, enroll in CMS ICD-10 Industry Email Updates. The Academy and AAOE will also be sending regular ICD-10 emails with tips and advice to help you stay on track between now and the Oct. 1 transition date.

    The Updated CMS 1500 Claim Form

    Beginning April 1, all practices must begin using the new CMS 1500 claim form, version 02/12. CMS began accepting version 02/12 beginning Jan. 6.

    The biggest changes in this version enable box 21 (diagnosis or nature of illness or injury) to accommodate ICD-10 codes:

    • The box now includes room for up to 12 diagnosis codes;
    • Diagnosis codes are listed by letter rather than number; use these letters in box 24E;
    • Codes are ordered left-to-right then down, rather than descending by columns from left to right;
    • The brand-new field “ICD Ind.” in the upper right corner tracks the code set used. Enter a “9” through Sept. 30, unless you’re using the form during test week. From Oct. 1 on, enter “10” and use the ICD-10 code set.

    Read more about the updated CMS 1500 forms on the CMS website.

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    About the author: Jennifer Arbuckle, CPC, OCS, is an Academy coding specialist whose background includes coding, billing, compliance and reimbursement in both a small private practice and a large academic medical institution.