November 5, 2015 — On Oct. 1, 2015, health systems across the country transitioned to the International Classification of Diseases, 10th Revision – ICD-10. This change will enable providers to capture more details about the health status of their patients to improve patient care and public health surveillance.
The Centers for Medicare and Medicaid (CMS) has been carefully monitoring the transition and said it is pleased to report that claims are processing normally. Generally speaking, 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. For this reason, CMS said it will have more information on ICD-10 transition by late November.
With this in mind, CMS is continuing its vigilant monitoring process of the ICD-10 transition and can share the following metrics detailing Medicare Fee-for-Service claims from 10/1-10/27.
There have been a total of 4.6 million claims per day. CMS said the rejection rate due to incomplete or invalid information is about 2 percent of all claims submitted.
Claims rejected for invalid ICD-10 codes is 0.09 percent. By comparison, CMS said rejection rates due to invalid coding with the previous ICD-9 system was 0.11 percent.
The total claims rejected amount to about 10 percent, CMS said.
CMS said it is important to know help remains available for providers experiencing issues with ICD-10:
• For general ICD-10 information, we have many resources on the CMS Road to 10 website and www.cms.gov/icd10.
• The first line for help for Medicare claims questions is your Medicare Administrative Contractor. They will offer regular customer service support and respond quickly.