First ICD-10 End-to-End Testing Yields Positive Results

With the International Classification of Diseases, Tenth Revision (ICD-10), definitely being implemented on October 1, 2015, CMS just completed the first week of end-to-end testing of the new coding.

More than 600 providers and billing companies submitted nearly 15,000 test claims during the first week of ICD-10 testing. ICD-10 codes are more specific than the current ICD-9, which will allow for better understanding about a patient’s health, according to CMS.

According to statistics released by CMS, 81% of the test claims received were accepted. While 3% of claims were rejected due to invalid submission of ICD-9 diagnosis or procedure code and another 3% from invalid submission of ICD-10 diagnosis or procedure code, the majority of rejected claims were for reasons unrelated to ICD-10.

“Overall, participants in the January 26 to February 3 testing were able to successfully submit ICD-10 claims and have them processed through our billing systems,” CMS Administrator Marilyn Tavenner wrote in a blog post. “To the extent that some claims were rejected, most didn’t meet the mark because of errors unrelated to ICD-9 or ICD-10.”

ICD-10 implementation has been fraught with challenges. Preparedness for ICD-10 has varied greatly across the industry with providers showing the least progress in the last year, according to a survey from the Workgroup for Electronic Data Interchange.

The initial round of end-to-end testing was supposed to take place in May 2014, just 5 months before what was then an October 1, 2014, implementation deadline. However, after a Congressional mandate delayed ICD-10 by at least 1 year, CMS canceled testing all together last year.

The United States is the last industrialized nation to adopt ICD-10, and the World Health Organization will release the ICD-11 code set, at the earliest, in 2017. Since ICD-10 is a foundational building block, it must be implemented before the US can move onto ICD-11.

Any services that are provided on or after October 1 will need to use ICD-10, but any services provided before October 1, even if the codes are not submitted until after that date, will need to use ICD-9. Prior to October 1, ICD-10 can only be used for testing purposes.

And Ms Tavenner strongly recommended in her blog post that medical practices and hospitals take advantage of ICD-10 testing opportunities to ensure they will be prepared for the transition date.

“I appreciate the tremendous efforts and achievements of health professionals as we work together to realize the benefits of ICD-10 and other advances toward the ultimate goal of improving the quality and affordability of health care for all Americans,” she wrote.