Healthcare Technology Featured Article

January 22, 2014

WEDI Wants More Robust Testing among Trading Partners Before ICD-10 Goes Live in October

The Workgroup for Electronic Data Interchange (WEDI) has an important job. It is a nonprofit organization concerned with the use of health IT to improve healthcare information exchange, and advises the U.S. Department of Health and Human Services. WEDI’s members include hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations and standards bodies.

Given recent problems with the rollout of the health insurance exchanges under the Affordable Care Act (Obamacare), its statements are being carefully watched. So interest was high when earlier this month WEDI chairman Jim Daley recommended in a letter to Health and Human Services Secretary Kathleen Sebelius that there be more Medicare ICD-10 testing, which relates to the processing of claims and codes.

In fact, the organization recommends “robust testing with a range of trading partners” such as hospitals, physicians (including large and small practices from different medical specialties), clinics, clearinghouses and Medicare secondary payers.

“This will give the industry a higher level of confidence that the Medicare claims processing system will operate as intended when ICD-10 goes live,” according to the letter.

The testing should take place before ICD-10-CM and ICD-10-PCS are implemented, the organization said. ICD-10-CM and ICD-10-PCS medical codes will replace the previously adopted ICD-9-CM medical code set for diagnosis and inpatient procedure coding.

Thorough testing is “critical to avoid significant disruption to the industry,” the organization warned in a statement. It also wants industry progress monitored and testing results early “to better gauge what may happen when ICD-10 implementation goes into effect,” the statement adds.

“WEDI has been working with public and private sectors of the industry to facilitate implementation of ICD-10 for many years and recognizes that this change in medical code sets may be the single largest technical, operational and business implementation in the healthcare industry in the past thirty years,” the letter said. “The use of diagnosis and procedure codes impacts nearly every application and business process in hospitals, physician offices and health plans, as well as vendor applications and clearinghouse functions. As such, this mandate will require the most significant testing effort to date.” 

Edited by Cassandra Tucker

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