A weeklong test of the ICD-10 coding system by 500 providers resulted in a 76% acceptance rate, according to CMS.
Recent end-to-end testing of the ICD-10 coding system produced a 76% acceptance rate, the Centers for Medicare ad Medicaid Services (CMS) has announced.
During the weeklong testing from November 17 to 21, more than 500 providers, suppliers, billing companies and clearinghouses submitted 13,700 claims. The acceptance rate averaged 76% overall, but by the end of the testing week, it rose to 87%, said CMS in a statement.
Accepted clams had a valid diagnosis code verified by CMS that matched the date of service, a National Provider Identifier (NPI) that CMS verified as valid for the submitting entity, and an ICD-10 companion qualifier code. Claims that were rejected contained an incorrect NPI, a future date for service, or had a missing ICD-10 companion qualifier code.
“Negative testing” - the submission of claims with deliberately incorrect information – was also undertaken to test the claims rejection process, said CMS.
READ: ICD-10: What now?
The ICD-10 coding system was developed in 1992 to replace outdated ICD-9 codes and first proposed for adoption by the U.S. Department of Health and Human Services in 2008. ICD-10’s 68,000 codes will replace 13,000 ICD-9 codes and will increase the specificity of reporting and improve national healthcare initiatives such as meaningful use, value-based purchasing, payment reform, and quality reporting, according to CMS.
Official implementation has twice been delayed, most recently in May of 2014. But the current implementation deadline of October 2015 is not likely to be extended again, say experts.
Minimize the trouble of ICD-10: test your system early and often
FDA Approves First At-Home Cervical Cancer Screening Device
May 15th 2025Self-collected samples to test for cervical cancer are a step in the right direction when it comes to addressing healthcare barriers, according to Rahma S. Mkuu, Ph.D., M.P.H., assistant professor in the Department of Health Outcomes & Biomedical Informatics at the University of Florida College of Medicine.
Read More
Conversations With Perry and Friends: Paul Fronstin, Ph.D.
May 9th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. In this episode, his guest is Paul Fronstin, Ph.D., director of health benefits research at the Employee Benefit Research Institute.
Listen
Conversations With Perry and Friends
April 14th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. His guest this episode is John Baackes, the former CEO of L.A. Care Health Plan.
Listen
The First Financial Toxicity Tumor Board Reports Success in Individual Patient Savings
May 14th 2025Financial toxicity can affect patient outcomes and quality of life. For example, a patient may forgo treatment or medications to save money, or they may incur high medical debt or go into bankruptcy to pay for medical care.
Read More