The Centers for Medicare and Medicaid Services has announced that providers, clearinghouses, and billing agencies for the most part successfully participated in the first ICD-10 end-to-end testing week.
The testing, conducted January 26 to February 3, included 661 providers as well as all Medicare Administrative Contractors and the Durable Medical Equipment MAC Common Electronic Data Interchange contractor, with billing companies submitting nearly 15,000 test claims.
Overall, participants in the week-long testing were able to successfully submit 81 percent of ICD-10 claims14,929 test claims were received and 12,149 were accepted. Among the reasons for rejected claims: invalid submission of ICD-9 diagnosis or procedure code (3 percent), invalid submission of ICD-10 diagnosis or procedure code (3 percent), and non-ICD-10 related errors including issues setting up the test claims (13 percent).
This successful week of testing continues to put us on course for successful implementation of this important initiative that better reflects modern practice of medicine by Oct. 1, 2015, writes CMS Administrator Marilyn Tavenner in a Feb. 25 blog. CMS is ready for ICD-10. And, thanks to our many partnersspanning providers, health plans, coders, clearinghouses, professional associations and vendor groupsthe healthcare community at large will be ready for ICD-10 on October 1.
According to the agency, the testing demonstrated that CMS systems are ready to accept ICD-10 claims. Earlier this month, a Government Accountability Office report concluded that efforts by CMS to prepare providers, clearinghouses, and health plans for the October 1 ICD-10 deadline are on track and that the agency is ready to process claims using the new codes.
When it came to professional and supplier claims submitted during the Jan 26-Feb. 3 testing, there were no issues identified and zero rejects due to front-end CMS systems issues, reports CMS. However, in the area of institutional claims, there was one issue identified related to system edits: home health claims with dates that spanned the October 1, 2015, implementation date were not processed correctly and contained ICD-10 codes but were returned to the submitter. CMS states that it impacted less than 10 test claims and that this issue will be resolved prior to the next testing week, and testers will have an opportunity to re-submit these claims.
Additional opportunities for ICD-10 end-to-end testing are slated for April and July. Testers who participated in the January testing are automatically eligible to test again if they choose.
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