CMS' First ICD-10 Claims Check-up Looks Good

  • By
  • In CMS
  • November 4, 2015
  • Comments Off on CMS' First ICD-10 Claims Check-up Looks Good
CMS' First ICD-10 Claims Check-up Looks Good

Metrics for Oct. 1-27 provided by the Centers for Medicare & Medicaid Services (CMS) indicate claims are processing normally, the agency claims. Especially heartening for CMS is that rejected claims, so far, are below the baseline in all but one category.
Comparing claims during that period with historical data and results of this year’s end-to-end testing, CMS said the data looks like this:

Metrics October 1-27 Historical Baseline*
Total Claims Submitted 4.6 million per day 4.6 million per day
Total Claims Rejected due to  incomplete or invalid information 2.0% of total claims submitted 2.0% of total claims submitted
Total Claims Rejected due to invalid ICD-10 codes 0.09% of total claims submitted 0.17% of total claims submitted
Total  Claims Rejected due to invalid ICD-9 codes 0.11% of total claims submitted 0.17% of total claims submitted
Total Claims Denied 10.1% of total claims processed 10% of total claims processed

CMS said more data will be available later in Novembers, as Medicare claims take several days to be processed and, once processed, Medicare must– by law – wait two weeks before issuing a payment. Medicaid claims can take up to 30 days to be submitted and processed by states.

Brad Ericson
Latest posts by Brad Ericson (see all)

About Has 394 Posts

Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor. He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.

Comments are closed.