CMS says ICD-10 billing system test successful

The Centers for Medicare & Medicaid Services says a recently completed end-to-end test shows its billing systems are prepared for the switch to ICD-10 in October.

Between Jan. 26 and Feb. 3, 661 physicians, other health care providers, and billing companies volunteered to send test claims to the Medicare Administrative Contractors (MACs) and the Durable Medical Equipment MAC Common Electronic Data Interchange (CEDI) contractor. Unlike ICD-10 acknowledgement testing, which simply determines if the tester’s claim is accepted or rejected, the end-to-end tests process the claims through all Medicare system edits and provide an Electronic Remittance Advice.

Of the total 14,929 test claims, Medicare’s billing system accepted 12,149, or 81 percent. CMS said in a news release that most of the rejected claims failed for technical reasons, such as using an incorrect National Provider Identifier (NPI) number, using a date of service outside the study range, or submitting an incorrect ICD-10 code. The agency said it found and will address a system issue that caused a handful of home health claims to process incorrectly. But officials said they found no issues affecting front-end CMS systems for professional and supplier claims.

“Testing demonstrated that CMS systems are ready to accept ICD-10 claims,” CMS said.

CMS is planning two more end-to-end tests this year. While the agency has already chosen volunteers for the April 27-May 1 test, it is still looking for providers to test the system July 20-July 24. Volunteer forms will be made available at MAC and CEDI websites on March 13.

For more information, download the following Medicare Learning Network (MLN) articles:
• “ICD-10 Limited End-to-End Testing with Submitters for 2015,”
• “FAQs – ICD-10 End-to-End Testing,”
• “Medicare FFS ICD-10 Testing Approach.”