Health Information Management

CMS' first round of end-to-end testing a success

HIM-HIPAA Insider, March 2, 2015

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Add another nail in the “delay ICD-10 because the industry isn’t ready” coffin.

 
CMS declared its end-to-end testing week from January 26 through February 3 a success. A total of 661 volunteers submitted 14,929 test claims, with CMS accepting 81% (12,149 claims).
 
CMS rejected 13% of the claims for reasons not related to ICD-10, such as:
  • Incorrect National Provider Identifier
  • Dates of service outside the range valid for testing
  • Invalid HCPCS codes
  • Invalid place of service
Three percent of claims contained an invalid ICD-10-CM and 3% had an invalid ICD-10-PCS codes, leading CMS to reject the claims.
 
More than half (56%) of the claims fell under professional services and 38% were institutional claims. Suppliers submitted 6% of the claims.
 
CMS identified zero issues related to professional and supplier claims and stated that none of the claims were rejected because of front-end submission problems.
 
CMS did find one system problem related to institutional claims, but it affected fewer than 10 total claims. It will fix the problem before the next end-to-end testing week April 26-May 1.
 
This article originally appeared on HCPro’s ICD-10 Trainer blog.

 



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