More ICD-10 Information

The Centers for Medicare and Medicaid Services (CMS) reports that they have conducted another round of successful acknowledgement testing of International Classification of Diseases v. 10 (ICD-10) claims submissions. During this most recent round of November testing, almost 13,700 claims were submitted from more than 500 providers, suppliers, billing companies and clearinghouses. CMS feels that this most recent round of submissions showed significant improvement with an 87 percent acceptance rate. 

Critical factors that contribute to a successful claim submission included:

• a valid diagnosis code that matched the date of service;
• a National Provider Identifier (NPI) that was valid for the submitter ID used for testing; and
• an ICD-10 companion qualifier code to allow for the processing of claims.

In many cases, testers intentionally included errors in their claims to make sure that the claim would be rejected, a process often referred to as “negative testing.” 

CMS scheduled additional testing weeks, including March 2-6 and June 1-5. In addition, providers are welcome to submit acknowledgement test claims anytime up to the Oct. 1, 2015 implementation date.

For more information:

• MLN Matters® Article MM8858, "ICD-10 Testing - Acknowledgement Testing with Providers”
• MLN Matters® Special Edition Article SE1409, “Medicare FFS ICD-10 Testing Approach,” which also includes information on opportunities for end-to-end testing with Fee For Service Medicare.

End-to-End Testing

In addition to acknowledgement testing, during the week of April 26 through May 1, 2015, a second sample group of providers will have the opportunity to participate in ICD-10 end-to-end testing with the Medicare Administrative Contractors (MACs) and the Common Electronic Data Interchange (CEDI) contractor. The goal of end-to-end testing is to demonstrate that:

• providers and submitters are able to successfully submit claims containing ICD-10 codes to the Medicare Fee-For-Service (FFS) claims systems;
• CMS software changes made to support ICD-10 result in appropriately adjudicated claims; and
• accurate remittance advices are produced.

The deadline to volunteer for the April end-to-end testing is Jan. 9, 2015. Volunteer forms are available on the National Government Services (NGS) website.

For more information from NGS on both acknowledgement and end-to-end testing, please click here.

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827