GAO report: CMS won't know ICD-10 readiness until code processing begins

CMS has conducted extensive testing of the systems implemented to support transitions to ICD-10, but the true functionality of those systems will not be fully known until code processing begins on Oct. 1, according to a U.S. Government Accountability Office study.

"While CMS' actions to update, test and validate its systems, and plan for contingencies can help mitigate risks and minimize impacts of system errors, the extent to which any such errors will affect the agency's ability to properly process claims cannot be determined until CMS' systems begin processing ICD-10 codes," the report reads.

The report details CMS' claims processing systems updates, the testing and validating of those system changes in order to minimize the impact of system errors, the technical support CMS will offer stakeholders in processing claims and the estimated cost of updating CMS' systems — approximately $116 million thus far.

Although the report's authors caution that "unanticipated system errors could disrupt Medicare claims processing when systems are required to begin processing ICD-10 codes," they emphasized that CMS has taken actions to determine and implement the necessary changes minimize potential disruptions.

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