CMS official: ICD-10 test week sees nearly 90% claims approval

The Centers for Medicare & Medicaid Services accepted 89 percent of ICD-10 front-end test claims submitted by providers, suppliers, billing companies and clearinghouses in March, according to Niall Brennan, acting director of the agency's Offices of Enterprise Management.

Brennan, in a post to CMS.gov on Friday, said a total of 2,600 participants submitted more than 127,000 claims with ICD-10 codes to the Medicare fee-for-service claims system. Some regions reported acceptance rates of 99 percent, he said.

Clearinghouses, he added, submitted 50 percent of those claims, the largest of all testers.

"Normal" claims acceptance rates hover between 95 and 98 percent, according to Brennan.

"This testing week allowed an opportunity for testers and CMS alike to learn valuable lessons about ICD-10 claims processing," Brennan said. "In many cases, testers intentionally included such errors in their claims to make sure that the claim would be rejected, a process often referred to as negative testing."

All potential testers, Brennan said, can submit acknowledgement test claims up to Oct. 1, 2015, but suggested that providers wait until after Oct. 6, 2014, when Medicare updates its systems; CMS is expected to publish an interim final rule soon that will mandate the use of ICD-10 coding beginning on that date.

While further end-to-end testing that had been planned for July was canceled last month by CMS, Brennan confirmed that additional testing will take place in 2015. Details, he said, will be released soon.

In April, the transition to ICD-10--which had been scheduled to take place on Oct. 1 of this year--was delayed for the second time in nearly two years when President Obama signed the Protecting Access to Medicare Act into law. The legislation mandated that ICD-10 could not be adopted prior to Oct. 1, 2015, and also implemented a 12-month patch to the sustainable growth rate payment formula that prevented deep Medicare payment cuts for physicians.

For more:
- read Brennan's post

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