- As the Oct. 1 conversion to ICD-10 approaches, CMS announced its third and final round of testing for its Medicare claims processing system, conducted July 20-24, was a success.
- The end-to-end testing showed that problems identified during previous rounds of testing had been resolved, and no new problems were identified, the agency stated.
- CMS says it had an 87% acceptance rate for the 29,286 claims received from 1,200 providers and billing companies participating in the testing.
CMS says no claims were rejected due to CMS systems problems, and that most rejections were caused by submission errors.
The agency says 2.6% were rejected due to the invalid submission of ICD-9 codes; 1.8% were rejected due to invalid ICD-10 diagnosis or procedural codes; and others had errors with data such as national provider identifiers, health insurance claim numbers, and dates of service that fell outside the testing range.
CMS suggests some of the errors were submitted by testers intentionally, in order to make sure those claims would be rejected.
Not everyone is convinced, however, that CMS is ready.
Health IT consultant and ICD-10 expert Stanley Nachimson notes CMS' pass-through rates for the final round of testing were similar to those in its earlier rounds.
“Remember, these are people who believe they are ready,” Nachimson told Modern Healthcare. “And with the errors [CMS] are still encountering, it sounds like there are issues in setting up the [providers'] new systems. We don't know what's happening to those entities who haven't prepared or been involved in the testing yet.”