CMS Announces More Successful ICD-10 Testing, Names Ombudsman | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

CMS Announces More Successful ICD-10 Testing, Names Ombudsman

September 1, 2015
by Rajiv Leventhal
| Reprints

The Centers for Medicare & Medicaid Services (CMS) has announced another successful round of week-long ICD-10 end-to-end testing.

Medicare fee-for-service (FFS) healthcare providers, clearinghouses, and billing agencies participated in a third successful ICD-10 end-to-end testing week with all Medicare Administrative Contractors (MACs) and the Durable Medical Equipment (DME) MAC Common Electronic Data Interchange (CEDI) contractor from July 20 through 24, 2015, the agency said. CMS was able to accommodate most volunteers, representing a broad cross-section of provider, claim, and submitter types.

Approximately 1,200 submitters were selected to participate, including 493 returning testers from the January and April testing weeks. Approximately 1,400 National Provider Identifiers (NPIs) were registered to test, of which 174, or 12 percent, were repeat NPIs from previous testing weeks. This indicates that many clearinghouses that participated in previous weeks chose different providers for July.

This round of testing resulted in an 87 percent acceptance rate. During the first ICD-10 end-to-end testing week, which took place from January 26 until February 3, 81 percent of claims were accepted; on June 2, the agency announced that 88 percent of submitted claims were accepted in t he second round of testing, which took place from April 27-May 1. The deadline for ICD-10 implementation is Oct. 1, 2015.

Overall, participants in the July end-to-end testing week were able to successfully submit ICD-10 test claims and have them processed through Medicare billing systems. In some cases, testers may have intentionally included errors in their claims to make sure that the claim would be rejected, a process often referred to as “negative testing,” CMS said.

CMS revealed that about 1.8 percent of test claims were rejected due to invalid submission of ICD-10 diagnosis or procedure code, while 2.6 percent of test claims were rejected due to invalid submission of ICD-9 diagnosis or procedure code.

Additionally, CMS has announced the hiring of an ICD-10 ombudsman to oversee the new medical coding system, beginning on Oct. 1. The ombudsman, William Rogers, M.D., is currently an emergency room physician and director of CMS’ Physicians Regulatory Issues Team.

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

NIH Releases First Dataset from Adolescent Brain Development Study

The National Institutes of Health (NIH) announced the release of the first dataset from the Adolescent Brain Cognitive Development (ABCD) study, which will enable scientists to conduct research on the many factors that influence brain, cognitive, social, and emotional development.

Boston Children's Accelerates Data-Driven Approach to Clinical Research

In an effort to bring a more data-driven approach to clinical research, Boston Children’s Hospital has joined the TriNetX global health research network.

Paper Records, Films Most Common Type of Healthcare Data Breach, Study Finds

Despite the high level of hospital adoption of electronic health records and federal incentives to do so, paper and films were the most frequent location of breached data in hospitals, according to a recent study.

AHA Appoints Senior Advisor for Cybersecurity and Risk

The American Hospital Association (AHA) has announced that John Riggi has joined the association as senior advisor for cybersecurity and risk.

Report: Healthcare Accounted for 45% of All Ransomware Attacks in 2017

Healthcare fell victim to more ransomware attacks than any other industry in 2017, according to a new report from global cybersecurity insurance company Beazley.

Study: Use of EHRs Does Not Reduce Administrative Costs

A recent study by Duke University and Harvard Business School researchers found that costs for processing a single bill ranged from $20 for a primary care visit to $215 for an inpatient surgical procedure, or up to 25 percent of revenue.