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Nov 3 2015   12:42PM GMT

ICD-10 conversion goes quietly in its first month

Alex Delvecchio Alex Delvecchio Profile: Alex Delvecchio

Tags:
CMS
ICD-10
ICD-10 conversion
ICD-10 implementation

The number of codes increased, but not much else has changed in the world of U.S. medical coding since the Oct. 1 ICD-10 conversion date. At least that’s the message conveyed by CMS’ recent update on the first month post-ICD-10.

A CMS report — comparing claims made from Oct. 1 through Oct. 27 to historical claims data — found that 10.1% of total submitted claims were denied in October. That figure was only 0.1% higher than the historical baseline — an increase of slightly more than 124,000 claims. The percentage of claims rejected in October because of invalid ICD-10 codes was only 0.09% of total claims, down from an average of 0.17% of claims rejected during end-to-end ICD-10 testing periods conducted previously this year. During a testing period in January and February, 13% of claims submitted to CMS were denied for reasons unrelated to ICD-10, far exceeding the 3% of denials caused by improper ICD-10 claims.

The number of claims submitted per day during the October stretch was 4.6 million. That number didn’t budge from the historical daily figure, according to CMS. The number of claims rejected due to incomplete or invalid information also stayed the same, sticking at 2% of all claims.

The years-long buildup to the ICD-10 conversion had some healthcare professionals planning for worst-case scenarios; planning for retirement from their physician practices, expecting interruptions to their revenue cycles and projecting reductions in their productivity once they started working with the new codes. The early returns indicate all that worrying hasn’t yet resulted in a proportional amount of post-implementation problems.

Though CMS said claims have been processed normally since the ICD-10 conversion, it could be too soon to declare the move a complete success. It can take as many as 30 days for states to process Medicaid claims, meaning some claims made shortly after Oct. 1 may still be in process.

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