CMS has announced the results of its second ICD-10 end to end testing week conducted from April 27 through May 1, 2015 for Medicare Fee-For-Service (FFS) health care providers, clearinghouses, and billing agencies. CMS was able to accommodate most volunteers, representing a broad cross-section of provider, claim, and submitter types. Approximately 875 providers and billing companies participated, and testers submitted over 23,000 test claims.
Key results include:
• The acceptance rate for April was higher than January, with an increase in test claims submitted and a decrease in the percentage of errors related to both ICD-9 and ICD-10 diagnosis codes.
- 23,138 test claims received • 20,306 test claims accepted
- 88% acceptance rate
- 2% of test claims were rejected due to invalid submission of ICD-10 diagnosis or procedure code
- <1% of test claims were rejected due to invalid submission of ICD-9 diagnosis or procedure code
• Professional and Supplier Claims – No issues identified and zero rejects due to front-end CMS systems issues.
• Institutional Claims – One issue identified related to system edits: Certain inpatient hospital test claims were inappropriately processed due to a systems issue with codes that are exempt from Present on Admission reporting. This issue will be resolved prior to the July end-to-end testing week, and testers will have an opportunity to re-submit these test claims.
• The home health issue discovered during the January end-to-end testing week was resolved prior to the April testing. January testers had the opportunity to re-submit these test claims, and they were processed correctly.
Tester education will be conducted to avoid common testing environment errors in preparation for the final July end-to-end testing week. Testers who participated in the January and April testing weeks are automatically eligible to test again in the July testing week.
