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February 14, 2018

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All Systems Go for ICD-10 Claims Processing

September 16, 2015:

The latest end-to-end testing week for ICD-10 claims submissions indicates that participating health care providers, clearinghouses, and billing agencies are poised for a smooth transition to ICD-10. Of the nearly 30,000 test claims submitted from July 20 through July 24, 87 percent were accepted.

The Centers for Medicare and Medicaid Services notes that some of the test claims contained intentional errors to test the rejection function, making the rate of successful claims submission higher than 87 percent. This compares favorably with the successful submission rates of 81 percent during the January testing week and 88 percent in April.

Claims were rejected for various reasons: 4.4 percent were denied because of invalid ICD-10 or ICD-9 codes, and the rest because of incorrect national provider identifiers, health insurance claim numbers, or submitter IDs; and invalid dates, HCPCS codes, and place of service. CMS attributes most of the denials to submission errors specific to the testing environment that will not occur after the new coding system is implemented.

No new problems related to ICD-10 were discovered in any of the Medicare fee-for-service claims processing systems.


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