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.