Physician Practice

Providers appear ready for ICD-10 according to latest end-to-end testing results

Physician Practice Insider, September 8, 2015

With less than one month until implementation, CMS says it’s ready for ICD-10, and so are many providers, according to the results from the agency’s final week 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.

Another successful round of testing is a good sign for the industry, but it doesn’t mean every provider is truly ready for ICD-10. Some providers wanted to volunteer but weren’t accepted or able to get a slot to participate with their clearinghouse.

In a recent poll of readers, 26% said they were extremely confident their organization would be ready for ICD-10, while 23% said they were not confident at all. Another 52% responded they were only somewhat confident their organizations would be ready by October 1.

This article originally appeared in APCs Insider.

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