Health Information Management

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

HIM-HIPAA Insider, September 21, 2015

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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 website.

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