ICD-10 Resource Readiness Checklist

As of October 1st, 2015, all ICD-9 codes will need to be converted to ICD-10 codes. This will take major preparation from your team in advance to ensure that all of your documentation is complete and ready for the transition.

Mediware has been proactive in staying on top of the changing ICD-10 requirements so that customers will be ready for the change ahead of time. Our software solutions are equipped for the coding changes to ensure your team a smooth transition. ICD-10 changes are only a burden if you allow them to be; start early, plan ahead, and make sure your entire team is fully committed on how to prepare.


1. What types of transactions will be impacted by ICD-10?

Some Mediware products have tested with CMS in collaboration with customers, as CMS requires actual claims data to be utilized. Fastrack and CPR+ are two of the Mediware products that have tested with Medicare, both which passed and are compliant.

    • Health Care Claim: Professional (837)
    • Health Care Claim: Institutional (837)
    • Health Care Services Review – Request for Review and Response (278)
    • Health Care Eligibility Benefit Inquiry and Response (270/271)
    • Benefit Enrollment and Maintenance (834)
    • Pharmacy Claims: NCPDP D.0

2. What is the new format for ICD-10 Codes?

ICD-10 codes are formatted as:

    • 3 – 7 digits
    • Digit 1 is alpha
    • Digit 2 is numeric; and
    • Digits 3 – 7 are alpha or numeric (alpha digits are not case sensitive).
    • Some, but not all, contain decimals.

3. What is the status of Mediware products in regards to ICD-10 coding changes?

Mediware provides ICD-9 to ICD-10 mapping tools, in conjunction with their products, which are based on the General Equivalency Mapping (GEM) files published by CMS. The GEM files provide “general equivalency” mapping between ICD-9 and ICD-10 codes—they do not in any way guarantee clinical accuracy. Clinical review and analysis is always necessary to ensure the accuracy of the mapping for a particular patient case, even in cases where there is a direct mapping between the ICD-9 and ICD-10 codes. Consulting with the Physician regarding the most accurate translation is an important component of this process. The following versions for each application must be implemented to utilize the tools developed by Mediware to assist in mapping your ICD-9 codes to ICD-10 codes:

Product Version
Fastrack Version 2014 or Higher
CPR+ Version 9.2a or Higher
HC360 Version 2013 R2 or Higher
MestaMed Patch Level 20778 or Higher
Caretinuum Version 2015 or Higher
CareTend Version 2015 or Higher

 

4. Has Mediware tested with CMS and if so, are they compliant?

Some Mediware products have tested with CMS in collaboration with customers, as CMS requires actual claims data to be utilized. Fastrack and CPR+ are two of the Mediware products that have tested with Medicare, both which passed and are compliant.

5. Are providers required to test with Medicare?

No. Testing weeks are currently scheduled for CMS and if you are interested in participating in organized testing with Medicare, please contact them for enrollment information:
http://ngscedi.com/ngs/portal/ngscedi/icd10testing

If you are selected, please notify your Customer Care team for your product for assistance in testing, if needed. Please be advised that you should be on the most current version of your Mediware software product in order to test effectively.

6. Are providers required to test with Zirmed?

No, Zirmed does not require providers to test. We do, however, strongly encourage providers to set up a test with Zirmed. Providers should contact Zirmed directly to set up the test. A copy of Zirmed’s process is attached. Please be advised that you should be on the most current version of your Mediware software product in order to test effectively.

7. Are providers required to test with Emdeon?

Please contact Emdeon to verify their testing requirements.

8. Once the proper version of my software is in place are there any additional steps needed to prepare for the ICD-10 transition?

Yes, in preparation for the ICD-10 go live, users will need to map current ICD-9 codes to ICD-10 codes using the functionality that is provided within their associated Mediware application. This may be a large project depending on the size of your patient population so it is a good idea to begin this as soon as possible.

9. When can the proces of mapping the codes start?

As long as you are on the version of your Mediware software that offers the mapping functionality, you can start at any time. We encourage customers to be contacting their prescribers for assistance in this process and for validation on the ICD-9 to ICD-10 selections. The process by which your transition will be successful will include many resources and potentially clinical input in instances where there are many to one associations. The earlier you get started on identifying these, the better!

10. What other information do you have regarding CEDI (Medicare) Testing?

To learn about ICD-10 testing opportunities for Medicare FFS providers, please click here.

11. I would like to know more information about CMS and their policies about end-to-end testing., where do I go to find this?

To learn more about these clarifications from CMS, please click here.

12. How do I find out more information about my ICD-10 readiness if I am a current customer?

Please email cpr-support@mediware.com for questions.