Health Information Management

CMS discusses ICD-10 end-to-end testing results, coding guidance

HIM-HIPAA Insider, September 21, 2015

Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

CMS has released a transcript and recording of its August 27 MLN Connects Call featuring ICD-10 coding guidance and the results of CMS’ final round of end-to-end testing.

CMS Acting Administrator Andy Slavitt provides a national implementation update and how CMS has prepared its systems for the transition.

Sue Bowman, RHIA, CCS, senior director of coding policy and compliance for AHIMA in Chicago, and Nelly Leon-Chisen, RHIA, director of coding and classification for the American Hospital Association in Chicago, follow with some of the latest coding advice and guidance available.

The call also includes the results of CMS’ third and final round of end-to-end testing in July. The round of testing resulted in a similar acceptance rate to January and April testing weeks—but with the largest group of volunteers yet. Approximately 1,200 volunteers, from a broad range of provider, claim, and submitter types participated, including 493 who participated in previous testing weeks.

Testers submitted a record 29,286 claims and CMS accepted 25,646 of them, resulting in an 87% acceptance rate. This is a similar rate to previous testing weeks, and most rejections were the result of provider submission errors that would not occur with actual claims, according to CMS. Errors include incorrect NPIs or submitter IDs, invalid HCPCS codes, and dates of service outside of the range of testing.

Coding errors also led to rejections, with 1.8% of claims rejected due to an invalid ICD-10 code and 2.6% rejected due to an invalid ICD-9-CM code. Some of these errors may be due to providers intentionally submitting invalid codes to make sure the claim would be rejected.

Additionally, CMS rejected no claims due to front-end system issues and identified no new ICD-10-related issues in the Medicare fee-for-service claims processing systems.

Editor’s note: This article originally appeared on the HCPro JustCoding.com website.



Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular