Tuesday, October 13, 2015

Providers and clearinghouses will populate the database by providing information about 10 key metrics:



Providers and clearinghouses will populate the database by providing information about 10 key metrics:
  1. Payer name/line of business.
  2. Is the payer indicating that it will map from ICD-10 to ICD-9?
  3. Is the payer indicating that it will dual code in ICD-9 and ICD-10?
  4. Testing type/testing date/returning information/triggering ICD-10 edits/dates of service.
  5. The URL from the payer’s website where information on their ICD-10 testing (including the testing plan) can be found.
  6. Does the payer allow for the scheduling of future service testing dates?
  7. Will a clearinghouse need to set up a new connection for ICD-10 testing?
  8. Will the payer be rejecting or denying claims for unspecified diagnosis codes? 
  9. Is provider and submitter registration required? 
  10. With whom will the payer be supporting testing?
“As more and more payers’ testing information goes online, this will be the most dynamic tool for providers and clearinghouses to have as they plan and execute their testing strategies,” said CE Executive Director Tim McMullen.


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