CMS End-To-End ICD10 Testing – April Results

CMS conducted the second round of end-to-end testing of claims with ICD10 data during the third week of April. MEDTranDirect, and one of our customers, Kimble Hospital of Junction, TX, were selected by Novitas for this round of testing.

As part of the testing process, 30 claims were sent for processing through our 837Direct product in a single batch. Most contained ICD10 codes and future dates, some contained ICD9 and current dates. All the submitted claims processed properly and the corresponding 999s and 277CA records were received.

In addition, CMS provided test 835 electronic remittance files that contained payment and adjustment data for the test claims reflecting how they will be paid in October.

ICD10 Testing
ICD10 Testing

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ICD10 Implementation – Possible Delays Pending

With just a few months to go until ICD10 implementation, there is still some chance that implementation might be delayed yet again.

On 4/30/15, Representative Ted Poe of Texas introduced a bill to ban the use of ICD10.

The bill is called the “Cutting Costly Codes Act of 2015”. It prohibits the federal government from requiring the use of ICD10 instead of ICD9. Poe claims that the implementation of the new code set will put unnecessary strain on the medical community.

Possible Delays Pending

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Electronic Claim Processing – Can Your Software Do Math?

As a vendor of software that edits and creates ANSI 837 claim files, we try to stay informed regarding the processing of these transactions.  One method that I recommend for all Medicare providers is to make sure that you obtain the memos issued by CMS through the Medicare contractors (MAC).

From time to time, the MACs distribute top ten lists of the most common errors they find in processing claims.  I received a list today from Novitas.  This list is further broken down by state.  The one I am referencing in this article is for New Jersey for April of 2015, but I think you will find that it is representative of all Medicare part A provider claim processing throughout the country.

Can your software do math?
Electronic Claims Processing Errors

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Evolution and Healthcare IT

When I was taught the theory of evolution in school, I was under the impression that species evolved slowly, over millions of years, leading steadily toward more advanced life forms more capable of dealing with their environment.  I can still remember the  March of Progress or the “ape to man” illustrations of earlier versions of our species, each appearing to be more like us and standing more upright as you moved left to right through the images.

As an adult, I learned more about how evolution actually worked.  In nature, it never was a straight line from less efficient species to more efficient ones.  The reality was that nature adapted to its environment through trial and error.  For every advancement through genetic mutation, millions of mutations created less efficient organisms that never survived.  In addition, from time to time, mass extinction events wiped out a majority of the species on earth leaving nature to start over, nearly from scratch.  This lead to two different evolutions of dinosaurs and the eventual rise of the mammals.

March of Progress
Matt Groening – Homersapien


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