Results from ICD-10 Acknowledgement Testing Week highlight problem areas

The Centers for Medicare and Medicaid Services recently performed an ICD-10 acknowledgement test that showed the areas of the system that are working and others that needed improvement. Experts were pleased to see that the Medicare Fee-for-Service claims systems revealed no issues. However, the results did show a lower national rate of accepted test claims when compared to the last testing in March.

CMS releases testing results 

The testing took place during the week of Nov. 17 and included nearly 13,700 claims and over 500 billing companies, providers, suppliers and clearinghouses, according to Modern Healthcare. The number of test claims accepted by CMS improved throughout the week. 

"Acceptance rates improved throughout the week with Friday's acceptance rate for test claims at 87 percent," the CMS said in Medicare Learning Network Connects update. "Nationally, CMS accepted 76 percent of total test claims. Testing did not identify any issues with the Medicare FFS claims systems."

CMS reported that the test was conducted to ensure a smooth transition to ICD-10, verifying each test claim to make sure it had three criteria. The first was a valid diagnosis code that matched the date of service, then an ICD-10 companion qualifier code to allow for processing of claims, and finally a National Provider Identifier that was valid for the submitter ID used for testing. CMS also noted that some testers intentionally included an error in their claims to confirm that flawed claims would be rejected. 

What are the problem areas?

According to BussinessSolutions, the majority of the issues and reasons for failed claims were invalid NPI's. Meanwhile, other claims contained future dates that the acknowledgement testing does not accept. Another major problem area involved claims that did not have an ICD-10 companion qualifier code, which is required when using ICD-10. All of the claims with these problems were immediately rejected. 

These results highlighted that many providers are still unable to submit claims with ICD-10 codes to CMS, while stressing the strict standards that CMS expects each claim to adhere to in order to be accepted. 

This was the first of a three-part acknowledgment testing series, with two other testing periods scheduled for March and June, according to EHR Intelligence. The CMS urged providers to refer to the agency's ICD-10 guidance page on its website, where frequently asked questions regarding the testing program are answered. This will assist participating providers in ensuring that their claims will be accepted during the following testing period.