The Centers for Medicare and Medicaid Services says it completed its final Medicare fee-for-service end-to-end testing of ICD-10 with positive results.

“This final end-to-end testing [that occurred July 20-24] demonstrated that CMS systems are ready to accept and process ICD-10 claims,” the agency said in an email update.

A separate report on the most recent testing noted that “no new ICD-10 related issues were identified in any of the Medicare fee-for-service claims processing systems. There were zero rejects due to front-end CMS systems issues,” and concerns from previous tests were resolved prior to the final testing week.

The final test was based on 1,200 participants, including physicians, health care providers, clearinghouses, and billing agencies. They submitted more than 29,000 test claims, including some that were intentionally erroneous to make sure a claim was rejected.

The agency reported an 87% acceptance rate, with 1.8% of test claims rejected because of invalid submission of ICD-10 diagnosis or procedure codes and 2.6% of test claims rejected due to invalid submission of ICD-9 diagnosis or procedure codes.

The acceptance rate (88%) was consistent with the previous test from April 27 to May 1 and up from the 81% acceptance rate reported during the Jan. 26–Feb. 3 testing period.

Additional rejections were generated from non-ICD-10 related errors, including incorrect NPI, health insurance claim number, or submitter ID; dates of service outside the range valid for testing; invalid HCPCS codes; and invalid place of service.

“Most rejects were the result of provider submission errors in the testing environment that would not occur when actual claims are submitted for processing,” the agency said in a report.

The ICD-10 compliance date is Oct. 1; however, CMS announced in July that during that first year using the new coding system, Medicare will not deny claims based solely on the specificity of diagnosis codes, provided they are in the appropriate family of ICD-10 codes.


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