January 26, 2015

AAPC: ICD-10 Testing Considered Successful

By

“ICD-10 implementation has not been as hard as they thought it would be, and … overall it has improved processes and documentation in their practices.”

Similar comments were echoed by many of the more than 2,000 respondents who participated in a recent AAPC ICD-10 Testing Survey.

 

Of the respondents, 84 percent of those who had taken part in ICD-10 testing considered it to be a success. Seventy-two percent of respondents saw no claims denied during testing. An additional 16 percent experienced a rejection rate of less than 10 percent. More than 90 percent of respondents said they noticed no payment shift on test claims.

Approximately one in three of those surveyed performed testing with either Medicare or Medicaid. The remaining respondents tested with various private payers, suggesting that ICD-10 readiness among those payers is generally strong.

The AAPC survey also shed additional light on the costs of ICD-10 implementation. Here, too, we learned some good news: per-provider costs have been more manageable than many had speculated. For example, 72 percent of respondents to the AAPC survey said they’ve spent less than $5,000 per provider for ICD-10 implementation, while only 2 percent said they had spent either nothing or in excess of $10,000 per provider. These figures validate earlier AAPC cost estimates of $750-$3,500 per provider on average, depending on the size of your practice.

Coincidently, the AAPC survey results closely match those associated with the recent ICD-10 testing efforts conducted by the Centers for Medicare & Medicaid Services (CMS). Moreover, again, ICD-10 testing has brought unexpectedly good news to the healthcare industry.

For example, during the November 2014 testing period, CMS processed 13,700 claims from more than 500 providers, suppliers, billing companies, and clearinghouses. “Testing did not identify any issues with the Medicare FFS claims systems,” the agency ultimately reported. Overall, CMS accepted 76 percent of test claims. Acceptance rates improved throughout the week; by Friday the acceptance rate for test claims was 87 percent.

The results are more impressive when you consider that many testers “intentionally included errors in their claims to make sure that the claim would be rejected.” The most common errors are easily corrected and had nothing to do with ICD-10. For instance, per CMS, “the majority of rejections on professional claims were common rejects related to an invalid NPI. Some claims were rejected because they were submitted with future dates. Acknowledgement testing cannot accept claims for future dates.” 

If we continue to share results of testing and other implementation strategies, the industry will continue to benefit.

Rhonda Buckholtz, CPC, COPC, CPMA, CPCI, CHPSE, CRC, CDEO, CGSC, CPEDC, CENTC

Rhonda Buckholtz is the vice president of practice optimization for Eye Care Leaders. She has more than 25 years of experience in healthcare, working in the management, reimbursement, billing, and coding sectors, in addition to being an instructor. She is a past co-chair for the WEDI ICD-10 Implementation Workgroup, Advanced Payment Models Workgroup and has provided testimony ongoing for ICD-10 and standardization of data for NCVHS. Rhonda spends her time on practice optimization for Eye Care Leaders by providing transformational services and revenue integrity for Ophthalmology practices. She was instrumental in developing the Certified Ophthalmology Professional Coder (COPC) exam and curriculum for the AAPC. Rhonda is a member of the ICD10monitor editorial board and makes frequent appearances on Talk Ten Tuesdays.