CMS: ICD-10 Claims Acceptance Rate Rises

ICD-10The Centers for Medicare & Medicaid Services (CMS) continues to accumulate what it says are successful tests of handling claims with ICD-10 codes.

CMS says that 775 physicians and other providers submitted nearly 9,000 claims during acknowledgement testing in March, and 91.8 percent of those claims were accepted. The acceptance rate during same month last year was 89 percent. The increase was much sharper from last November, which was 76 percent at the time.

The types of errors that brought on a rejection included using an invalid National Provider Identifier (NPI) or one that was not on the NPI crosswalk, using an invalid HCPCS code or postal ZIP code, or using future service dates. CMS said the tests showed no issues in the fee-for-service billing system.

“Testing demonstrated that CMS is ready for ICD-10 and shows the tremendous progress of health professionals to be ready for the transition,” the agency states.

Health care providers have until October 1 of this year to switch to using ICD-10 codes.

Acknowledgement testing ensures that claims are received and then accepted or rejected, as opposed to end-to-end testing, which continues the test on to the submitter receiving an accurate remittance advice. CMS is performed end-to-end testing from April 27 to May 1 and will do so again from July 20 to July 24.

The final scheduled acknowledgement testing period is June 1 to June 5. Health care providers are able to conduct acknowledgement testing on their own at any time.

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Guide: Accountable Care Organizations

Click here to download our Guide: "How Independent Practices Can Succeed in a Healthcare Industry Shaped by ACO Programs". If you would like more information you can Request a consultation.

Practice Management

  • Anesthesia Billing
  • Full-service medical billing
  • Patient account management
  • Encounter form design
  • Patient balance collections
  • Learn More

MBA In The News

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