Health Information Management

News: Less than 2% of claims rejected due to invalid codes in ICD-10 end-to-end testing week

CDI Strategies, September 3, 2015

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ICD-10 implementation is 27 days away. CMS completed its third and final ICD-10 end-to-end testing week, July 20-24. According to the results released last week, only 1.8% test claims were rejected due to invalid ICD-10 diagnosis or procedure codes, and 2.6% were rejected due to invalid ICD-9 codes

Approximately 1,200 participants—including 493 return testers—submitted roughly 29,286 test claims, of which 87% were accepted, roughly the same as the April testing week, where a reported 88% of test claims were accepted.

CMS rejected the remaining claims due to incorrect National Provider Identifiers, Health Insurance Claim Number, or Submitter ID; dates of service outside the range valid for testing; invalid HCPCS codes; and invalid place of service. These types of errors occurred in both the January and April end-to-end testing weeks as well. Unlike previous testing weeks, CMS reported that most rejected claims were the result of provider submission errors in the testing environment that would not occur when actual claims are submitted for processing. Read the rest of the results here

According to CMS, testing demonstrated that systems are ready to accept ICD-10 claims. No new ICD-10-related issues were identified and there were zero rejects due to front-end CMS system issues. Issues identified during previous testing weeks were resolved prior to July testing.

Let the final countdown begin


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