DecisionHealth, DecisionHealth - 2015 Issue 10 (October)
Volume of ICD-10 claims low; real test could be next week
At the clearinghouse Navicure, in Duluth, Ga., the volume of claims arriving from providers remained at its usual high level – about 1 million claims a day – on Oct. 1, reports Ken Bradley, Navicure’s vice president for strategic planning and regulatory compliance.
But the volume of claims with ICD-10 codes was relatively low – around one quarter of the total volume, he says.
“I am hopeful that we won’t see a significant drop in the number of claims received due to ICD-10,” Bradley adds. “My fear is that some smaller practices have decided to wait a few days before deciding to submit claims with ICD-10 codes.” Decreasing claim volume could be an indication that practices are having trouble with the codes, technical or otherwise, he explains.
On the payer side, no payers have rejected claims because of ICD-10 codes, but that too could change once the ICD-10 code volume increases, Bradley says.
On day one of ICD-10, Navicure noticed some practices filing claims with ICD-10 codes right out of the gate, shortly after midnight. Bradley figures those were most likely test claims.
No one has yet used the Navicure portal to file claims directly – one of the contingencies practices may use if, for example, their electronic health records (EHRs) are unable to transmit ICD-10 coded claims. However, they have been using the portal to recode claims prior to resubmitting them.
That was the case for a number of providers who jumped the gun and tried to send ICD-10 claims with a date of service prior to Oct. 1, Bradley reports. That was “the No. 1 reason for Navicare rejections” Oct. 1, he adds. Normally, most clearinghouse-level rejections are related to eligibility.
A small percentage of practices – around 1.24% – continued to try to submit claims in an incorrect electronic format, despite an “aggressive” education campaign the clearinghouse has carried out for the last 18 months, Bradley says. Some even tried to include ICD-10 codes on those claims.
“We’re still continuing that effort today to reach out to those clients,” he adds.
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