CMS releases ICD-10 claim denial numbers

Just over 10 percent of claims filed since the implementation of ICD-10 on Oct. 1 have been denied, the Centers for Medicare & Medicaid Services reported on Oct. 29.

Of the 10 percent, 2 percent were reportedly rejected as a result of incomplete or invalid information, with 0.09 percent being denied due to the use of invalid ICD-10 codes.

The metric for claim denials is based on “end-to-end testing conducted in 2015,” CMS notes on its factsheet. According to what’s published, there have been an average of 4.6 million total claims submitted per day since Oct. 1.

This is the first metric on progress to be released by CMS since the ICD-10 launch, though more accurate numbers are expected to be released in November, after more claims are processed.

“CMS has been carefully monitoring the transition and is pleased to report that claims are processing normally,” the organization states on its website.

Also worth noting, 0.11 percent of claims were reportedly rejected due to improper ICD-9 coding. In an effort to ease the transition process, CMS has previously stated they would not deny claims coded in the correct ICD-10 family.

Sponsored Recommendations

Care Access Made Easy: A Guide to Digital Self-Service for MEDITECH Hospitals

Today’s consumers expect access to digital self-service capabilities at multiple points during their journey to accessing care. While oftentimes organizations view digital transformatio...

Going Beyond the Smart Room: Empowering Nursing & Clinical Staff with Ambient Technology, Observation, and Documentation

Discover how ambient AI technology is revolutionizing nursing workflows and empowering clinical staff at scale. Learn about how Orlando Health implemented innovative strategies...

Enabling efficiencies in patient care and healthcare operations

Labor shortages. Burnout. Gaps in access to care. The healthcare industry has rising patient, caregiver and stakeholder expectations around customer experiences, increasing the...

Findings on the Healthcare Industry’s Lag to Adopt Technologies to Improve Data Management and Patient Care

Join us for this April 30th webinar to learn about 2024's State of the Market Report: New Challenges in Health Data Management.