Topics
More on ICD-10 & Coding

CMS says 10% ICD-10 claims rejected, but only a fraction due to coding issues

Of 4.6 million total claims submitted per day, 2 percent were rejected due to incomplete or invalid information, CMS said.

Susan Morse, Senior Editor

About 10 percent of claims filed under ICD-10 have been denied since the coding vocabulary became the norm on October 1, the Centers for Medicare and Medicaid Services said on Thursday, though only a small number of those denials were due to coding errors.

Of 4.6 million total claims submitted per day, 2 percent were rejected due to incomplete or invalid information, CMS said.

CMS released the metrics on claims submitted from October 1 through October 27.

[Also: RelayHealth logs $25 billion in ICD-10 claims]

Invalid ICD-10 codes were the basis for rejecting .09 percent of claims, and .17 percent of total claims submitted based on end-to-end testing.

Total claims rejected due to invalid ICD-9 codes represented .11 percent of submissions and .17 percent of total claims submitted based on end-to-end testing.

Total claims denied were 10.1 percent of total claims processed, CMS said.

[Also: ICD-10 arrives: Reactions from the first day]

Before the change, CMS had said it would not reject claims as long as they were coded using the correct ICD-10 family. Healthcare providers welcomed that since the 70,000 codes included ICD-10 mean they have to be more specific than ever with their coding.

CMS expects to release more information on the ICD-10 transition in November.

Since the transition, claims are processing normally. Medicare claims take several days to be processed and, by law, Medicare must wait two weeks before issuing a payment. Medicaid claims can take up to 30 days to be submitted and processed.

Twitter: @SusanJMorse