ICD-10 test sees 88 percent claims pass, few coding errors, CMS says

03 Jun 2015 3:48 PM | Brian Kelley

Of the 23,138 claims filed, 20,306 were accepted, though most of the rejections were caused by issues not related to ICD-10. 

retrieved from HealthCareFinanceNews.com
Henry Powderly, Managing Editor

More than 88 percent of ICD-10 claims filed during the latest round of Centers for Medicare and Medicaid Services end-to-end testing passed, the federal agency said, with only 2 percent of rejections coming as a result of ICD-10 coding errors in the claims.

CMS said 875 Medicare Administrative Contractors participated in the testing from April 27 through May 1, showing a higher success rate than the previous testing session in January.

The ICD-10 diagnostic coding vocabulary is expected to go live on Oct. 1. It contains nearly 70,000 codes, a major jump from the 14,000 codes in the current ICD-9 set.

Advocates say ICD-10 offers providers a way to be more detailed and targeted with their diagnosis records, which improves the overall health records that follow patients across their various healthcare providers.

While most of the world’s healthcare systems are already using ICD-10, the United States is unique in that its diagnostic codes are also used in reimbursement claims. That's what has ICD-10 opponents worried. In the worst case, coding errors can cause claims to be held or not paid, which strains on providers’ finances.

CMS said its latest round of testing suggests most providers are ready, though.

Of the 23,138 claims filed to its Common Electronic Data Interchange, 20,306 were accepted. Also, most of the rejections were caused by issues not related to ICD-10.

This round’s 88 percent acceptance was higher than its last round of testing in January, when 81 percent of claims went through.

CMS will hold another round of testing in July.


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