Non Functional Testing - ICD-10_Preetha

8/7/2019 Non Functional Testing - ICD-10_Preetha

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Need for Non FunctionalTesting in ICD-10Remediation

Need for Non-functional Testing in ICD-10

Remediation


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Confidential 2011 Syntel, Inc.

Overview of ICD - 10

ICD-10 Overview The U.S. Department of Health and Human Services (HHS) has proposed a regulation that would replace the

ICD-9-Clinical Modification code sets, now used to report healthcare diagnoses and procedures, with advancedICD-10 code sets. The recommended date of compliance is October 1, 2013.

The International Classification of Diseases and Related Health Problems (ICD) published by the World HealthOrganization (WHO) provides codes to classify diseases in detail.

Why Do We Need a ICD-10?

Reimbursement would enhance accurate payment for services rendered

Quality would facilitate evaluation of medical processes and outcomes

What Characteristics Are Needed in a Coding System?

Flexible enough to quickly incorporate emerging diagnoses and procedures

Exact enough to identify diagnoses and procedures precisely


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Benefits of Adopting the New Coding System

Benefits of Adopting the New Coding System

ICD-9 or earlier versions may be inadequate and do not provide sufficiently detailed information for healthresearch and statistical analysis.

ICD-9 or earlier versions are not flexible enough to quickly incorporate emerging diagnoses and procedures

Older versions cannot always pay claims fairly for example: ICD-9 has one code for Ulcer, but does not have

details on size, location, depth or number of ulcers. Where as ICD-10 has 60 decubitus codes and will be ableto identify the size, location, depth and whether patient has multiple ulcers. Hence ICD-10 has morecompatible to pay claims accurately.

Use of ICD-9 or earlier versions increased opportunity for fraud due to the number of different conditions or

procedures categorized to the same code (for example, an investigational procedure assigned to the samecode as a non-investigational procedure);

The countries like UK (1995), France (1997), Australia (1998), Belgium (1999), Germany (2000) & Canada (2001)have implemented ICD-10 for reimbursement of claims.


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Remediation

Need for Non-functional Testing in ICD-10 RemediationNon functional testing plays a major role in testing of ICD-10. Due to the vast and complex nature of the ICD-10implementation non functional testing cannot be ignored.

Compatibility Testing

Remediation of ICD-10 will require extensive technology modifications to databases, reports, computing logic,

data imports and extracts and workflow procedures, etc.

Checking the OS, Database etc

Response of the system across different browsers

Conformance Testing

Since ICD-10 is standard which is globally endorsed by various organizations and institutions it is necessary toperform Conformance testing to determine whether a product or system meets some specified standard thathas been developed for efficiency or interoperability.

Done by external organizations and sometimes by the standard body itself

To ensure Quality of service.


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Remediation

Migration testing

Impact on historical data used for underwriting and rating due to use of old ICD-9 codes and new ICD-10 codesand hence migration testing plays a vital role.

Recovery testing

Due to impact on historical data used old ICD-9 codes and new ICD-10 codes it is essential to perform Recovery

testing to verify that recovery is properly performed and historical data is not affected.

Volume Testing

Testing an application with certain amount of data.

If you want to volume test your application with a specific database size, you will expand your database to thatsize and then test the application's performance on it.

Security testing

To avoid Potential increase in fraud and abuse, Security testing is important.


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Remediation

Performance testing

Performance testing is required to avoid Claims backlogs and payment delays due to coding and

reimbursement discrepancies, operating capacity of the system.

Stress Testing

ICD-9 contains around 17,000 codes, ICD-10 contains more than 150,000 codes. Stress Testing is required toensure accurate processing of ICD-9 and ICD-10 codes coexisting in a single database.

Load testing

Adding more demand to the system and measuring its response

Identifying maximum operating capacity of the system under normal and in peak load conditions


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Q & AQ & A


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Thank you.Thank you.

Documents

Non Functional Testing - ICD-10_Preetha