Health Information Management

CMS completes another round of successful ICD-10 end-to-end testing

APCs Insider, June 5, 2015

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By Steven Andrews
 
CMS has completed another round of successful ICD-10 end-to-end testing, with the acceptance rate climbing substantially from the first effort in January.
 
In the latest test, conducted from April 27 to May 1, CMS accepted 88% of claims submitted, with only 2% rejected due to an invalid ICD-10-CM/PCS code, down from 3% in the January test. In the first test, CMS accepted 81% of claims, prompting the AMA to predictably portend disaster for an October 1 transition.
 
This isn't the only positive trend in the latest testing data. Less than 1% of claims were rejected due to invalid ICD-9-CM codes, while this number was at 3% in January. Approximately 10% of the remaining claims were rejected due to:
  • Incorrect NPI, Health Insurance Claim Number, or submitter ID
  • Dates of service outside the range valid for testing
  • Invalid HCPCS codes
  • Invalid place of service codes
If claims were submitted today with those errors, they'd also be rejected. Providers presumably will be able to iron out those errors before implementation. If you focus on just the coding-related errors, we're left at 97% acceptance, precisely the rate CMS accepts today.
 
CMS found no issues with front-end systems for professional and supplier claims, and only identified one issue related to system edits for inpatient claims, which will be resolved before the next round of tests in July. CMS also noted that the error identified in January regarding home health claims was fixed for this round.
 
How ready are you for ICD-10? HCPro is presenting weekly ICD-10 refresher webcasts all summer to prepare coders and providers for the upcoming transition. The webcasts cover a variety of topics and specialties, information on anatomy, documentation, and tricky coding conventions. For more information, visit HCMarketplace.com.



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