Health Information Management

News: CMS ICD-10 testing ongoing

CDI Strategies, January 8, 2015

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More than 500 providers, suppliers, billing companies, and clearinghouses participated in ICD-10 acknowledgement testing during its November 2014 round, CMS announced recently. Testers submitted 13,700 claims and although the acceptance rate hovered around 75%, acceptance rate climbed to nearly 90% by week’s end.

Acknowledgement testing allows organizations to submit ICD-10 test claims and electronically notifies them if claims are accepted. The majority of denied claims were due to invalid National Provider Identifiers, claims with future dates, and claims without an ICD-10 companion qualifier code. Some testers intentionally submitted claims with errors to ensure the claims could be rejected if appropriate.

 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 has scheduled two additional acknowledgement testing weeks for March 2–6, 2015, and June 1–5, 2015.

CMS also plans to conduct end-to-end testing (during which participants will be able to submit ICD-10 claims and receive Remittance Advice that explains the adjudication of the claims) January 26-30 and April 26 through May 1, and July 20-24.

Each MAC (and Common Electronic Data Interchange with assistance from DME MACs) will randomly select 50 submitters from each jurisdiction from a pool of volunteers to participate. Each MAC will post forms for volunteers on its website. Selected participants will be notified in February.

Editor’s Note: For more information, visit your MAC website or view MLN Matters® SE1409. Portions of this article were adapted from the ICD-10 Trainer Blogand the HIM-HIPAA Insider.

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