Of the approximately 1,500 test claims received by the Centers for Medicare & Medicaid Services (CMS) during ICD-10 testing week, 81 percent were accepted, CMS announced.
CMS says it was able to accommodate all 661 participants—providers and billing companies—during the first successful ICD-10 end-to-end testing week, which took place from January 26 until February 3. Reasons for rejected claims included:
- 3 percent due to an invalid submission of an ICD-9 diagnosis or procedure code
- 3 percent due to an invalid submission of an ICD-10 diagnosis or procedure code
- 13 percent due to non-ICD-10 related errors, including issues setting up the test claims
In a blog post praising the results of testing week, outgoing CMS Administrator Marilyn Tavenner, R.N., identified one point that had caused some confusion in the healthcare community and beyond. “We are communicating far and wide that everyone must use: ICD-9 for services provided before the October 1 deadline; and ICD-10 for services provided on or after October 1. That means ICD-10 can be used only for test purposes before October 1. And, only ICD-10 can be used for doctor’s visits and other services that happen on or after October 1. ICD-9 cannot be used to bill for services provided on or after October 1. This rule applies no matter when the claim is submitted, so claims submitted after October 1, 2015, for services provided before that date must use ICD-9 codes,” Tavenner said.
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.