background-news-events.jpg

Exceptional Coders | Innovative Technology

CMS Testing of ICD-10 “Successful & Ready to Take Next Step”

Posted by Ben Castleberry on Apr 8, 2015 11:44:00 AM

Over 660 providers and billing companies submitted nearly 15,000 test claims for ICD-10 during a 1-week period.  How were the results? According to Marlilyn Tavenner, Administrator at Centers for Medicare and Medicaid Services (CMS), responsible for running the test, results were deemed a “success & demonstrated a readiness to accept ICD-10 Claims”. ICD-10

 

Overall, participants were able to successfully submit ICD-10 claims and have them processed through billing systems. Here is a deeper look at the results of the ICD-10 CMS ran testing:

 

  • 14,929 test claims received
  • 12,149 accepted – 81%

 

Reasons for rejected claims:

  • 3% invalid submission of ICD-9 diagnosis or procedure code
  • 3% invalid submission of ICD-10 diagnosis or procedure code
  • 13% - Non-ICD-10 related errors, including issues setting up the test claims (e.g., incorrect NPI, Health Insurance Claim Number, Submitter ID, dates of service outside the range valid for testing, invalid HCPCS codes, invalid place of service.)

 

Types of claims received:

  • 56% Professional
  • 38% Institutional
  • 6% Supplier

 

 

Provider types that participated in the January testing:

Type

Percent of Testers

Ambulance

1.8

Ambulatory Surgical Center

1.0

Behavioral Health Provider

0.6

Clinic/Group

0.3

Durable Medical Equipment Supplier

11.5

End Stage Renal Disease Provider

1.9

Federally Qualified Health Center

0.3

Home Health Agency

0.9

Hospice

1.0

Hospital - All Others

23.4

Hospital – Critical Access Hospital

2.9

Hospital – Psychiatric

2.2

Hospital - Inpatient Rehabilitation

2.5

Imaging/Testing

0.5

Lab

2.2

Non-MD

3.6

Other

3.1

Primary Care

4.9

Rural Health Clinic

1.0

Skilled Nursing Facility

3.1

Specialists

31.3

 

 

The success of the ICD-10 testing demonstrates a readiness to the CMS. With the October 1, 2015 date nearing, and the passing of SGR through the house, there is a strong indication that ICD-10 will be a reality.

 

 

About Aviacode

Aviacode is an industry leader in technology-enabled medical coding services. Aviacode’s coding software and workflow improve the accuracy and efficiency of medical coding. This process of translating clinical documentation into diagnosis and procedure codes is the core of the healthcare revenue cycle. These improvements impact hospitals and physician groups profoundly through improved efficiency, improved clinical documentation, patient care, and increased revenue.

 

 

 

References:

“Successful ICD-10 Testing Shows Industry Ready to Take Next Step to Modernize Health Care” blog.CMS.gov. Feb 25, 2015

“ICD-10 Medicare FFS End-to-End Testing: January 26 through February 3, 2015”. CMS.gov