Validating ICD-10

The references and links below may not have been edited to include the proposed implementation date change.

The Testing Phase of the ICD-10 plan is critical to a successful implementation. Testing will help verify the proper use of ICD-10 processes, procedures and systems, and will help validate alignment between you and external entities (e.g., your trading partners and vendors). Testing starts with the development of a comprehensive test strategy and test plan. It is important to share these early deliverables both internally and externally to ensure low-risk, high-quality output from the testing process.

After implementing ICD-10 changes to systems, you will need to complete several types of tests. First, you may decide to complete unit testing of individual components, system testing of integrated components and performance testing of all components. Many of these tests will be similar to ones performed for other IT changes. Second, you will need to complete specific ICD-10 end-to-end testing as described in the ICD-10 Final Rule.

The ICD-10 Testing Tables in the CMS ICD-10 Implementation Guide Books  contain very detailed descriptions of the types of testing required for ICD-10. The testing tables may be found on the following pages:

  • Pages 43-46, Table 14 – Implementation Guide for Small and Medium Practices
  • Pages 41-45, Table 14 – Implementation Guide for Large Practices
  • Pages 54-56, Table 19 – Implementation Guide for Small Hospitals

External Testing

Another important part of testing is to help ensure that all of the changes you have made will work with the partners with whom you interact. In order to test you need an open dialogue with your partners to coordinate how and when you can test with them.

BCBSTX intends to conduct testing well in advance of the revised implementation date as defined in the proposed rule from April 2012. The approach to our testing will include participants in a controlled pilot test environment to ensure day-to-day business is not impacted. The benefits you will receive from participating in testing with us are:

  • A controlled test environment may help you identify process and system issues before your revenue is at risk
  • Refine and revise business flows to maximize efficiency
  • Allow for early benchmarking of performance data
  • Help anticipate coding delays
  • Possibly avoid disruption of cash flow
  • For facilities, understanding potential impacts to payments and allowed amounts, especially to payment methodologies such as Diagnosis Related Grouping (DRG)
  • Dedicated team to assist with key activities during the testing, including on-boarding

If you would like to participate in testing, we need to understand where you are in terms of planning and incorporating ICD-10 codes within your processes and systems. To do this we ask that you take a Readiness Survey . The results of this survey will be considered along with other key criteria that we are using to help prioritize testing partners. Once you have completed the survey you will hear from BCBSTX providing further information. If you have been selected for testing you will receive a welcome packet providing specific details on the testing requirements.