You may remember the ICD-10 testing week that the Centers for Medicare and Medicaid Services (CMS) conducted in March of this year. Well, the results are in, and it was a success. Participants submitted more than 127,000 claims containing ICD-10 codes to Medicare “and received electronic acknowledgements confirming that their claims were accepted,” writes Niall Brennan, acting director of the CMS Offices of Enterprise Management, in the May 30, 2014, CMS ICD-10 News Update (which the Mississippi Hospital Association republished here).
About 26,000 providers, suppliers, billing companies, and clearinghouses (representing approximately 5% of the total submitting population) participated in the testing program, with clearinghouses making up the largest portion of participants and submitting half of all test claims. On the national level, CMS accepted 89% of test claims (the normal acceptance rate is 95–98%). However, some regions reported acceptance rates close to 99%.
According to Brennan, the “testing did not identify any issues with the Medicare [fee-for-service] FFS claims system”—which is great news—but the program did afford testers and CMS the opportunity to learn. “To be processed correctly, all claims must have a valid diagnosis code that matches the date of service and a valid national provider identifier,” writes Brennan. “Additionally, the claims using ICD-10 had to have an ICD-10 companion qualifier code…” Claims lacking any of the above were rejected. Brennan reports that many program participants intentionally submitted errored claims to ensure the rejection process was working correctly—a process known as “negative testing.”
The Department of Health and Human Services (HHS) plans to release an interim final rule that will include October 1, 2015, as the new mandatory ICD-10 compliance date. Under this proposed rule, HIPAA-covered entities will need to continue using ICD-9 through September 30, 2015. However, “providers, suppliers, billing companies, and clearinghouses are welcome to submit acknowledgement test claims anytime up the anticipated October 1, 2015, implementation date.” However, Brennan cautions, you may want to wait to do so until after October 6, 2014, when Medicare will complete its system updates. If you’re interested in conducting acknowledgement testing, please contact your local Medicare Administrative Contractor (MAC) for more information.
CMS will soon release details about another round of end-to-end testing slated for next year. We’ll pass along that info as soon as we receive it.