ICD-10 end-to-end testing yields 76% acceptance rate

December 29, 2014

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The ICD-10 coding system was developed in 1992 to replace outdated ICD-9 codes and first proposed for adoption by the U.S. Department of Health and Human Services in 2008.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