CMS Reports ICD-10 End-To-End Testing Results

By Megan Williams, contributing writer

CMS (the Centers for Medicare And Medicaid Services) recently announced the results of another successful acknowledgement testing. The process, which allows healthcare providers to submit claims under the new ICD-10 system and receive electronic confirmation of acceptance, is open to providers, suppliers, billing companies, and clearinghouses.

This round involved more than 500 healthcare providers, and tested almost 13,700 claims. Participating providers included “small and large physician practices, small and large hospitals, labs, ambulatory surgical centers, dialysis facilities, home health providers, ambulance providers, and several other physician specialties”, according to CMS.

Results
As the week progressed, acceptance rates for test claims came out at 87 percent. On a national level, CMS accepted 76 percent of total test claims. No issues with the Medicare Fee-for-Service (FFS) claims systems were identified.

Aiding The Transition
As part of smoothing the transition to ICD-10, CMS verified that all submitted claims during the test period had criteria including,

• Diagnosis codes that matched the date of service
• An NPI (National Provider Identifier) that was valid for the submitter ID
• An ICD-10 companion qualifier code allowing for processing of claims

As is normal, many testing participants engaged in “negative testing,” a practice that involves including deliberate errors in their claims to assure the claim would be rejected.

Most claim rejections involved professional claims related to NPI issues, but some were submitted with future dates.

The Next Round
CMS has scheduled the next round of testing for April 26-May 1, 2015 testing week are currently being solicited. The key goals of testing are to demonstrate:

• Providers and submitters can successfully submit claims using ICD-10 codes to the Medicare FFS systems
• Changes CMS has made in software support ICD-10 claim adjudication
• Accurate remittance advices are produced

If healthcare providers participated in January testing, they did not need to re-apply for the April session. More details available at CMS.

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