CMS: Successful April Medicare FFS ICD-10 End-to-End Testing

According to today’s announcement from the Centers for Medicare & Medicaid Services (CMS), ICD-10 implementation success is here.

Between Monday, April 27 and Friday, May 1, Medicare Fee-For-Service (FFS) healthcare providers, clearinghouses, and billing agencies contributed their collective efforts towards a second successful ICD-10 end-to-end testing week. Testing participation was with all Medicare Administrative Contractors (MACs) and the Durable Medical Equipment (DME) MAC Common Electronic Data Interchange (CEDI) contractor.

Healthcare experts and leaders have spoken out regarding where the industry should focus its energies between now and October. CMS maintains ICD-10 success is tangible, despite a heavy onset of revenue cycle doubt come October regarding heavy claim rejections and denials.

“This second end-to-end testing week demonstrated that CMS systems are ready to accept ICD-10 claims,” maintains CMS, referring to testers’ 23,000 test claims among 875 providers and billing companies.

April’s end-to-end testing week resulted in generally successful ICD-10 test claims and Medicare billing systems processing, CMS confirms. “Most of the claim rejections that occurred were due to errors unrelated to ICD-9 or ICD-10,” states CMS.

April’s end-to-end testing yielded positive results, according to CMS. 23,138 test claims were received and 20,306 test claims were accepted, with an overall 88 percent acceptance rate, confirms CMS’s data. Two percent of test claims were rejected due to invalid submission of ICD-10 diagnosis or procedure codes. Less than 1 percent of test claims were rejected due to invalid submission of ICD-9 diagnosis or procedure codes.

Compared to earlier testing conducted in January, April’s testing week resulted in increased test claims and fewer percentage errors related to diagnosis codes. CMS additionally confirms April’s acceptance rate surpassed January’s. According to CMS, most volunteers were accommodated. These volunteers embodied a wide-ranging cross section regarding the types of providers, claims, and submitters, confirms CMS.

“There is still time to get ready!” CMS asserts, in the midst of industry-wide trepidation. Additional testing is indeed on the summer horizon, from July 20 through July 24. Although volunteers for this testing week have already been finalized, acknowledgement testing may be completed at any time, CMS explains.

In the midst of a possible ICD-10 implementation freeze proposed by a House bill, CMS reminds the healthcare industry to be prepared for ICD-10 implementation. Medicare claims with a date of service on or after October 1 without a valid ICD-10 code will be rejected. Medicare claims processing systems lack the proficiency in accepting ICD-9 codes for dates of service after September 30. Additionally, the systems cannot accept claims with both ICD-9 and ICD-10 codes.

Get ready, get set, prepare.

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Photo courtesy of: Rev Cycle Intelligence

Originally published on: Revcycleintelligence.com