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Waiting on the CMS for ICD-10 details.

Few details have emerged from the Centers for Medicare & Medicaid Services since Congress delayed the implementation of the ICD-10 coding system earlier this year.

As part of Protecting Access to Medicare Act of 2014 (H.R. 4302), Congress delayed implementation of ICD-10 for at least a year. In May, CMS officials announced that the new compliance date would be Oct. 1, 2015, and that physicians and hospitals must continue to use ICD-9 through Sept. 30, 2015.

The agency said it would release an interim final rule in the "near future" with additional details about the compliance date.

Since then, the CMS canceled the end-to-end system testing that had been scheduled for July. The testing will be held sometime in 2015 instead, according to the agency.

But the CMS did report on results of acknowledgment testing conducted with Medicare fee-for-service contractors in March. During the test, providers, suppliers, billing companies, and clearinghouses sent more than 127,000 claims with ICD-10 codes to the Medicare fee-for-service claims system. They received an electronic acknowledgment if their claims were accepted. The exercise did not test whether the claims test had sufficient documentation to be paid by Medicare.

Overall, the CMS accepted 89% of the test claims, below the normal average Medicare claims acceptance rates of 95%-98%.

Negative testing--the purposeful submission of error-filled claims to force a rejection--could be one reason for the lower acceptance rate, according to Niall Brennan, acting director of the CMS Offices of Enterprise Management.

While physicians and other providers can submit claims for acknowledgment testing anytime up to the implementation date, Mr. Brennan recommended waiting until after Oct. 6, 2014, when Medicare updates its systems.

Physicians should contact their local Medicare Administrative Contractor for information on acknowledgment testing, according to the CMS.

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Title Annotation:Centers for Medicare & Medicaid Services, International Classification of Diseases; PRACTICE ECONOMICS
Publication:Pediatric News
Article Type:Brief article
Geographic Code:1USA
Date:Jun 1, 2014
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