Updated on: March 16, 2016

CMS Acknowledgement Testing Week Highlights Lingering ICD-10 Issues

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Original story posted on: December 8, 2014

Despite a decline in participation and some lingering issues still affecting providers, Centers for Medicare & Medicaid Services Provider Billing Group Director Diane Kovach told Talk-Ten-Tuesday listeners last week that she was pleased with the results from the second of four scheduled acknowledgement testing weeks being planned and coordinated by the agency.

 

“Overall,” Kovach said, “the testing went really well.”

Only two things were being scrutinized during the testing week that recently ended prior to the Thanksgiving holiday: the ability of providers to submit claims containing ICD-10 codes to CMS, and the ability of CMS to accept those codes, Kovach explained.

“These claims are not fully adjudicated in this testing,” she said. “It’s really just what we like to call ‘getting the claim in the door.’”

The first CMS Acknowledgement Testing Week was held in March. Participation in the most recent edition was “a little lower,” Kovach conceded, but there were two factors likely playing a factor in that area: First, the most recent ICD-10 delay, which “removed some of the sense of urgency” to get testing done in an expedient manner, she said, and second, a public stance regarding testing currently being taken by CMS.

“We’ve been public about our ability to do this testing with any provider at any time,” Kovach explained, “so we think some are taking advantage of that.” “You might ask, if we’re allowing testing at any time, why are we even having these highlighted weeks?” Kovach added. “The answer is simply that we want to draw extra attention to the availability of the acknowledgement testing – and we think that the highlighted weeks really help us to do that.”

Preliminary results of the second round of acknowledgement testing are still pending, as data is still being gathered by CMS. Official results will be issued in mid-December, but in the meantime, Kovach reported that approximately 7,800 ICD-10 claims were submitted, with about 5,700, approximately 73 percent, “getting in the door.”

That was a lower rate than which was recorded during the March session, with rates coming in higher for institutional claims than for non-institutional or supplier claims.

Kovach listed three reasons some codes were rejected, the first being an invalid ICD-10 code being submitted.

“We know last time that providers did do negative testing, where they purposely submitted an ICD-9 code, for instance, just to make sure that it was actually rejected,” she explained.

The two other reasons included that some providers put future dates on the claims – end-to-end testing does require such dates, but acknowledgement testing prohibits them – and some National Provider Identifier (NPI) issues, Kovach reported.

Kovach pledged to work with individual providers to address these and any related issues leading up to CMS’s first full-bore end-to-end testing week, which is scheduled for Jan. 26-30, 2015.

 “Test claims submitted during that week will go through full adjudication, all the way to remittance advice,” she said. “Results of that testing will be made available around the end of February.”

 

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.
Mark Spivey

Mark Spivey is a national correspondent for ICDmonitor.com who has been writing on numerous topics facing the nation’s healthcare system (and federal oversight of it) for five years.