CMS touts ICD-10 testing success

'CMS systems are ready to accept and process ICD-10 claims'
By Mike Miliard
09:12 AM
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Medicare fee-for-service providers, clearinghouses and billing agencies built on earlier successes during the final end-to-end testing week in July, according to the Centers for Medicare & Medicaid Services.

With 1,200 providers and billing companies participating, and testers submitting more than 29,000 claims, the third successful test week shows that "CMS systems are ready to accept and process ICD-10 claims," according to the agency.

Participants in the testing week successfully submitted ICD-10 test claims and that were processed through Medicare billing systems. The acceptance rate for July was similar to the rates for weeks in January and April, but with an increase in the number of testers and test claims submitted, CMS officials say:

  • 29,286 test claims were received
  • 25,646 test claims were accepted, for an 87 percent acceptance rate
  • 1.8 percent of test claims were rejected due to invalid submission of ICD-10 diagnosis or procedure code
  • 2.6 percent of test claims were rejected due to invalid submission of ICD-9 diagnosis or procedure code

In some cases, testers may have intentionally included errors in their claims to make sure that the claim would be rejected, a process often referred to as negative testing. Additional rejections were from non-ICD-10 related errors, such as incorrect NPI, Health Insurance Claim Number, or Submitter ID; dates of service outside the range valid for testing; invalid HCPCS codes and invalid place of service.

No new ICD-10 related issues were identified in any of the Medicare fee-for-service claims processing systems, according to CMS. There were zero rejects due to front-end CMS systems issues and issues identified during previous testing weeks were resolved prior to July testing.