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End-to-end ICD-10 testing mostly free of coding errors

Only 3% of ICD-10 claims submitted to CMS during a nine-day test were rejected. There were 661 providers, clearinghouses and billing agencies that participated and 1,400 were registered to test the soon-to-be implemented medical coding set. Here is a statistical breakdown of CMS’ ICD-10 testing, which took place from Jan. 26 to Feb.3, 2015.

  • 14,929 total test claims were received.
  • 12,149, or 81%, of all test claims were accepted.
  • 13% of the errors were unrelated to ICD-10 and were caused by issues with setting up test claims, such as listing an incorrect National Provider Identifier.
  • Not every participant had fully moved on from the last coding set; 3% of rejected claims were caused by the invalid submission of an ICD-9 code.

Marilyn Tavenner, outgoing CMS administrator, authored a blog post summarizing the agency’s findings. She wrote that ICD-9’s outdated structure limited the number of new diagnostic codes it could hold and that some ICD-9 categories have reached capacity and cannot be expanded. Upgrading to ICD-10 would permit providers to use more specific codes to accurately diagnose and treat patients. Tavenner explained CMS is performing thorough ICD-10 testing to see that healthcare providers will be paid for Medicare claims submitted after the Oct. 1 ICD-10 deadline.

The results from the most recent testing done by CMS were a step up from a previous week of voluntary testing it ran last November. Slightly more than three-quarters of submitted claims were accepted during that trial, though some of the faulty claims were intentionally submitted with errors — a method known as “negative testing.” CMS has scheduled an additional ICD-10 testing week for June 1-5, 2015.

Providers are optimistic about being ready for ICD-10 despite feeling like they’re behind in their preparations, according to a recent survey performed by Porter Research, commissioned by Navicure, Inc. When the survey was done in the first quarter of this year, less than a quarter (21%) of responding physician practices believed they were on track in getting ready for ICD-10, though 81% were optimistic they’d be prepared come Oct. 1. The majority of physicians aren’t banking on another delay, as 67% said they expect the current transition date to stick.

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