CMS releases latest ICD-10 test results
Late last month, the Centers for Medicare & Medicaid Services (CMS) announced the results of ICD-10 acknowledgement testing it conducted Nov. 17-21. Acknowledgement testing helps physicians and others find potential flaws in their own claims systems or that of Medicare by having them submit claims with ICD-10 codes and receive electronic confirmation that their claims were accepted.
According to CMS, more than 500 testers, including small and large physician practices, submitted almost 13,700 claims during the November testing week. Acceptance rates improved throughout the week, reaching 87 percent acceptance by Friday. Nationally, CMS said it accepted 76 percent of all test claims submitted and that testing did not identify any issues with the Medicare claims systems.
For test claims to be valid, CMS said they had to have a valid diagnosis code matching the date of service, a National Provider Identifier (NPI) that was valid for the submitter identified as making the claim, and an ICD-10 companion qualifier code to allow for processing of claims. Claims failing to have or meet one of these three criteria, such as a claim using a date of service in the future, were rejected. In many cases, testers intentionally included errors in their claims to make sure that the claim would be rejected, a process often referred to as “negative testing” – which also explains some of the 24 percent rejection rate.
Physicians and other Medicare providers are welcome to submit acknowledgement test claims anytime up to the ICD-10 implementation date of Oct. 1, 2015. However, CMS periodically designates special weeks for this purpose. The next upcoming acknowledgement testing week is March 2-6, followed by June 1-5.
For more information, physicians can contact their Medicare Administrative Contractor or read the following CMS publications:
• "ICD-10 Testing - Acknowledgement Testing with Providers”
• “Medicare FFS ICD-10 Testing Approach,” which also includes information on opportunities for end-to-end testing with Fee-for-service Medicare.
– Kent Moore, Senior Strategist for Physician Payment for the American Academy of Family Physicians
According to CMS, more than 500 testers, including small and large physician practices, submitted almost 13,700 claims during the November testing week. Acceptance rates improved throughout the week, reaching 87 percent acceptance by Friday. Nationally, CMS said it accepted 76 percent of all test claims submitted and that testing did not identify any issues with the Medicare claims systems.
For test claims to be valid, CMS said they had to have a valid diagnosis code matching the date of service, a National Provider Identifier (NPI) that was valid for the submitter identified as making the claim, and an ICD-10 companion qualifier code to allow for processing of claims. Claims failing to have or meet one of these three criteria, such as a claim using a date of service in the future, were rejected. In many cases, testers intentionally included errors in their claims to make sure that the claim would be rejected, a process often referred to as “negative testing” – which also explains some of the 24 percent rejection rate.
Physicians and other Medicare providers are welcome to submit acknowledgement test claims anytime up to the ICD-10 implementation date of Oct. 1, 2015. However, CMS periodically designates special weeks for this purpose. The next upcoming acknowledgement testing week is March 2-6, followed by June 1-5.
For more information, physicians can contact their Medicare Administrative Contractor or read the following CMS publications:
• "ICD-10 Testing - Acknowledgement Testing with Providers”
• “Medicare FFS ICD-10 Testing Approach,” which also includes information on opportunities for end-to-end testing with Fee-for-service Medicare.
– Kent Moore, Senior Strategist for Physician Payment for the American Academy of Family Physicians
Posted on Jan 06, 2015 by David Twiddy
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Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.