Because ICD-10 requires systems to capture additional and more complex data, system upgrades and even overhauls are necessary. These new and updated systems must be completely and thoroughly tested to validate proper transmission of data.
Here are some questions to ask yourself:
Have you migrated to ANSI 5010?
Although the switch to ANSI 5010 was mandated back in January 2012, many entities were not prepared and continue to use 4010. A number of clearinghouses still accept 4010 transactions, but after the implementation of ICD-10, clearinghouses will no longer be able to convert 4010 transactions. If the 5010 shift does not successfully happen, cash flow will come to a screeching halt starting Oct. 1, 2014.
Interface testing checklist
If you have not yet migrated to 5010, you should start there and use the checklist below to guide you through the process. If your 5010 migration is complete, this checklist should be used to test any new or upgraded systems.
1. Identify testing entities. This includes any entities you electronically transact with (incoming, outbound, etc.) and could include vendors and payers.
2. Determine what needs to be tested. Ask the following questions:
o What will remain the same?
o What will be different?
o What areas will electronic transactions involve?
3. Engage in a dialogue with each entity to identify specific, relevant testing needs. Some interfaces can be tested by simulation and checked off as tested until full end-to-end testing takes place.
4. Schedule testing. Understand time constraints and availability of each entity to participate.
5. Troubleshoot problems identified during testing. Follow standardized testing and Q&A methods and deploy any fixes. Retest until all test scenarios pass with expected results.
6. Document all test scenarios and findings, even if the test is incomplete. Proper documentation will add value when you begin end-to-end testing.
Interface testing should be completed by March 2014 in order to move on to end-to-end testing starting in April. Stay tuned for part two of this series where I will provide a checklist for end-to-end testing.
Elizabeth Morgenroth, CPC, Revenue Cycle Business Analyst at T-System Inc., has 16 years of healthcare experience in the payer, provider and vendor areas of service. While with Blue Cross and Blue Shield of Kansas, she provided coding assistance to all professional specialties statewide. Morgenroth was responsible and integral to the entire revenue cycle process for a family practice in Lawrence, Kansas with four physicians and five physician assistants. While working for Clinical Coding Solutions, she performed professional and facility coding for nearly all specialties. In her current position, she is responsible for encoder tool development and ICD-10 readiness for T-System revenue cycle solutions. Morgenroth attended the American Health Information Management Association (AHIMA) Academy for ICD-10-CM and ICD-10-PCS and is an AHIMA Approved ICD-10-CM and ICD-10-PCS Trainer.
This article first appeared in ICD-10Watch.