Health Information Management

CMS accepts 76% of ICD-10 test claims

HIM-HIPAA Insider, January 5, 2015

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CMS announced that it accepted 76% of all national ICD-10 test claims submitted during its November 2014 ICD-10 acknowledgement testing week. More than 500 providers, suppliers, billing companies, and clearinghouses participated in the tests.
CMS’ acknowledgement testing allows organizations to submit ICD-10 test claims at any time through the Medicare fee-for-service claims systems, which electronically notifies testers about whether their claims were accepted. During acknowledgement testing weeks all Medicare Administrative Contractor and Common Electronic Data Interchange contractor help desk lines are open to answer questions about test claims. Testers submitted 13,700 claims during the November test week. The daily acceptance rate climbed to 87% by Friday of the test week.
The majority of denied claims were due to invalid National Provider Identifiers. CMS also rejected all claims with future dates, because only claims with current dates of service are appropriate for testing. CMS rejected all ICD-10 claims without an ICD-10 companion qualifier code. Some testers intentionally submit claims with errors to ensure the claim will be rejected.
During the first ICD-10 acknowledgment testing period in March 2014, CMS accepted an average of 89% of claims from approximately 2,600 participants.
Typically, CMS accepts 95%-98% of Medicare fee-for-service claims.
CMS scheduled two additional acknowledgement testing weeks for March 2–6, 2015, and June 1–5, 2015.

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