Providers are getting better at transmitting claims with ICD-10 codes on them, and Medicare administrative contractors are getting better at processing them, CMS concluded after the latest round of acknowledgement testing last month.
 
Some 775 submitters sent 9,000 test claims during the testing week, the agency stated, and “CMS accepted 91.8% of test claims,” compared with an 87% acceptance rate during an acknowledgement testing week in November 2014 and 89% in March 2014.
 
Hold on, though. CMS also says it excludes from this year’s number the 8.2% of claims that were rejected because testers put future dates on their claims, which the agency says goes against testing rules. CMS made no mention of leaving erroneous date claims out of its previous test results.
 
CMS said this month that it has left out rejected claims from its data because “while this is an issue in the testing environment, it should not be a factor after implementation on Oct. 1.”
 
Other submitting errors turned up by the latest round of acknowledgment testing included:
 
  • An invalid national provider identifier (NPI) “or an NPI that was not on the NPI crosswalk” and
  • Invalid HCPCS codes or ZIP codes.
 
On the positive side, CMS reports that no Medicare fee-for-service “claims systems issues were identified during this testing week or the previous” ones. That’s better than January’s end-to-end testing week, when Medicare contractors hit a snag with home health claim testing (HHL 3/9/15).
 
Providers planning to participate in the June 1-5 acknowledgment testing week should bear in mind that Medicare will closely scrutinize these test claims, even though this is acknowledgment testing and not the more extensive end-to-end testing, during which the payers pretend to fully process claims for payment.
 
To have your acknowledgment test claims processed correctly, “all claims must have a valid diagnosis code that matches the date of service and a valid national provider identifier,” CMS explains.
 
Related link: View last month’s acknowledgement testing results at http://go.cms.gov/1cp1wX6.