CMS’ second-ever ICD-10 end-to-end testing week did not identify any issues with home health claims, and the home health problem discovered during January’s testing week was indeed fixed.
 
About 88% of claims received during the April 27-May 1 testing week were found acceptable by Medicare contractors, CMS announced June 2.
By comparison, about 81% of claims received were found acceptable during the prior testing week.
 
The home health issue discovered during January testing involved claims that contained dates spanning ICD-10’s Oct. 1 implementation date and containing ICD-10 codes. The claims were inappropriately rejected by Medicare administrative contractors due to “an issue in our claims processing software,” CMS said at the time.
 
CMS resolved the issue prior to April’s testing week, and “January testers had the opportunity to re-submit these test claims, and they were processed correctly,” a CMS release states.
 
During April’s testing week, about 875 businesses including providers, clearinghouses and billing agencies submitted ICD-10 claims and had them processed through billing systems. This includes providers that participated in January as well.
 
End-to-end testing processes claims through all Medicare system edits to produce and return an accurate electronic Remittance Advice.
Of 23,138 test claims received during April’s testing week, 20,306 test claims were accepted, CMS says.
 
About 2% of claims were rejected due to invalid submission of ICD-10 diagnosis or procedure code, and less than 1% of claims were rejected due to invalid submission of ICD-9 diagnosis or procedure code.
 
Most claims errors were unrelated to ICD-9 or ICD-10. Errors included incorrect national provider identifier (NPI), dates of service outside the range valid for testing and invalid HCPCS codes.
 
The lone new problem identified as a result of April testing involved certain inpatient hospital claims being inappropriately processed “due to a systems issue with codes that are exempt from Present on Admission reporting,” CMS says. The federal Medicare agency expects that issue to be resolved in time for next month’s end-to-end testing week.
 
The July testing week will be the final one held prior to ICD-10’s implementation. The deadline to apply to participate already passed.
 
Meanwhile, agencies can participate anytime in front-end testing, which provides agencies with electronic acknowledgments that claims submitted were received.
 
Related link: View CMS’ testing week results at http://go.cms.gov/1BHbdWU.