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Friday Apr 10, 2015

CMS sees ICD-10 claims acceptance rate rise in latest test

The Centers for Medicare & Medicaid Services (CMS) continues to rack up what it characterizes as successful tests of handling claims with ICD-10 codes.

CMS says 775 physicians and other providers submitted almost 9,000 claims during acknowledgement testing last month, and CMS accepted 91.8 percent of those claims. That is a higher acceptance rate than during acknowledgement testing weeks in November (76 percent) and March 2014 (89 percent).

The rejected claims included a number of user errors, such as using an invalid National Provider Identifier (NPI) or an NPI that wasn’t on the NPI crosswalk, using an invalid HCPCS code or postal ZIP code, or using service dates in the future. CMS said the tests revealed no problems in the fee-for-service billing system itself.

“Testing demonstrated that CMS is ready for ICD-10 and shows the tremendous progress of health professionals to be ready for the transition,” the agency said.

Physicians and other providers must switch to using ICD-10 codes beginning Oct. 1 of this year.

Acknowledgement testing, which ensures that the claim is received and then accepted or rejected, differs from end-to-end testing, which continues the test through to the submitter receiving an accurate remittance advice. CMS is completing end-to-end testing from April 27 to May 1 and from July 20 to July 24.

The final scheduled acknowledgement testing period is June 1-5. Physicians and other providers can conduct acknowledgement testing on their own at any time. You can contact your Medicare Administrative Contractor(www.cms.gov) for more information.

For more information, check out the following Medicare Learning Network (MLN) articles:

•    “FAQs – International Classification of Diseases, 10th Edition (ICD-10) Acknowledgement Testing and End-to-End Testing(www.cms.gov)"

•    “ICD-10 Testing - Acknowledgement Testing with Providers(www.cms.gov)

•    “Medicare FFS ICD-10 Testing Approach(www.cms.gov)

Posted at 12:27PM Apr 10, 2015 by David Twiddy

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