Slightly more than 3 in 4 claims submitted during a recent partial testing of more than 13,000 ICD-10 claims were accepted by CMS contractors, the CMS announced Tuesday.
Acceptance rates for the so-called “acknowledgement testing,” which involved 500 volunteer healthcare organizations, improved throughout the week with Friday's acceptance rate for test claims at 87%,” a CMS statement said. “Nationally, CMS accepted 76% of total test claims. Testing did not identify any issues with the Medicare (fee for service) claims systems.”
This round of testing allowed providers, billing companies and claims clearinghouses to determine whether CMS could accept their ICD-10-coded claims and return an acknowledgment to the sender that the claims had been accepted or rejected. Payments were not calculated for the coded claims.
A 24% non-acceptance rate is no cause for concern at this point, according to Stanley Nachimson, a health information technology consultant. Hopefully, Nachimson said, details will be released by the CMS in various outreach sessions later about what caused the rejections.
In the first round, a number of entities chose to send bad transactions, so-called negative testing, and that could account for some of the rejections, Nachimson said. “Given that we're relatively early in the testing, it's good to see if there were issues. The more transparency in the test results the better,” he said.
The CMS said most rejections of professional claims were caused by an invalid national provider identifier in the claim submitted for testing. Some claims bounced because they were submitted with future dates or lacked a needed “companion qualifier,” the agency said.
Additional acknowledgement testing sessions are scheduled March 2-6 and June 1-5, 2015.
The CMS is conducting a series of nationwide testing programs in advance of the federally mandated national shift to the ICD-10 diagnostic and procedural coding system on Oct. 1, 2015.
It conducted a similar round of tests last month and in January plans to begin a more rigorous series of “end-to-end” testing sessions with claims adjudication and communication back to the provider of a remittance advice.
A five-page CMS guidance answers frequently asked questions about the ICD-10 end-to-end testing program.
The CMS will be under congressional scrutiny next year in the run-up to the scheduled ICD-10 deadline, with a pair of GOP leaders, House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and House Rules Committee Chairman Pete Sessions (R-Texas) calling for hearings on national preparedness for the conversion.
Meanwhile, several physicians groups, led by the Texas Medical Association and the American Medical Association, are continuing in their opposition to the ICD-10 rollout.
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