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CMS Reports Only 10 Percent ICD-10 Claims Rejected

October 30, 2015
by Heather Landi
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Centers for Medicare & Medicaid Services (CMS) reports that claims are processing normally since the transition to ICD-10 on Oct. 1, with 10 percent of claims being rejected and only .09 percent rejected due to invalid ICD-10 codes.

CMS released metrics detailing Medicare Fee-for-Service claims from Oct 1 through Oct. 27 with 4.6 million claims submitted per day during that time period. Of those claims, 2 percent of claims were rejected due to incomplete or invalid information, and 0.11 percent of claims were rejected due to invalid ICD-9 codes. CMS reports that of total claims processed during that time period, 10.1 percent were denied, which is on par with CMS’ historical baseline.

Medicare claims take several days to be processed and, once processed, Medicare must– by law – wait two weeks before issuing a payment.  Medicaid claims can take up to 30 days to be submitted and processed by states. For this reason, CMS states that it will have more information on the ICD-10 transition in November.

Before the change, CMS had said it would not reject claims as long as they were coded using the correct ICD-10 family.




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