Health Information Management

CMS' second end-to-end testing week a success

HIM-HIPAA Insider, June 15, 2015

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CMS declared its second week of ICD-10 end-to-end testing, held from April 27 through May 1, a success.
 
Approximately 875 participants submitted 23,138 test claims during the week and CMS accepted 88% of the claims. CMS rejected only 2% of claims for an incorrect ICD-10 code and less than 1% for an incorrect ICD-9-CM code. During the first week of end-to-end testing, CMS rejected 3% of claims for incorrect ICD-10 codes and 3% of claims for incorrect ICD-9-CM codes.
 
CMS rejected the remaining claims for errors not related to coding, such as:
  • Incorrect National Provider Identifiers, Health Insurance Claim Number, or Submitter ID
  • Dates of service outside the range valid for testing
  • Invalid HCPCS codes
  • Invalid place of service
 
These types of errors also accounted for the majority of rejected claims during the first end-to-end testing week in January.
 
Half of the test claims came from professional services, 43% from institutions, and 7% from suppliers. During the first testing week, which CMS also declared a success, 56% of the claims fell under professional services and 38% were institutional claims. Suppliers submitted 6% of the claims.
 
CMS identified one system error for institutional claims. CMS’ system inappropriately processed certain inpatient hospital test claims due to a systems issue with codes that are exempt from Present on Admission reporting. CMS plans to resolve this error before the final week of end-to-end testing in July.

This article originally appeared on HCPro’s ICD-10 Trainer blog.



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