Medical Billing and Coding Healthcare Blog

The Centers for Medicare & Medicaid Services (CMS) is hosting a free MLN Connects National Provider Call that will discuss the Clinical Diagnostic Laboratory Test Payment System proposed rule on November 10 from 2:00-3:00 p.m. Eastern.

The proposed rule — CMS-1621-P — would significantly revise the Medicare payment system for clinical diagnostic laboratory tests and implement a related data collection system. We previously wrote about the rule here.

To register, click here. CMS notes that this call will not include a Q&A session.

If you're struggling with the increasing regulatory demands associated with clinical laboratory billing, contact PGM Billing. PGM has worked with clinical and reference labs for the past 30-plus years, making them one of the nation's top medical billing companies and a leading provider of laboratory billing solutions. Find out what PGM can do for you today.

The Centers for Medicare & Medicaid Services (CMS) has announced it rejected 10.1% of Medicare fee-for-service claims submitted October 1-27, 2015, with the new ICD-10 codes.

On October 1, 2015, health systems transitioned to ICD-10.

Between October 1-27, CMS processed 4.6 million claims per day, a similar figure as compared to its historical baseline. It rejected 10.1% of them, as compared to the usual 10%.

Of the 10.1% of total claims denied during the October period, 2% were rejected due to incomplete or invalid information, 0.09% were rejected due to invalid ICD-10 codes, and 0.11% were rejected due to invalid ICD-9 codes.

CMS noted that, generally speaking, Medicare claims take several days to be processed and, once processed, Medicare is required to wait two weeks before issuing a payment. Medicaid claims can take up to 30 days to be submitted and processed by states.

As such, CMS indicated it will provide more information on the ICD-10 transition in November; we will share that news when it becomes available.

To help reduce the likelihood of having your claims denied, use our ICD 10 codes lookup tool, just one of the many PGM practice management tools designed to help providers determine correct medical procedure codes and perform other coding and billing tasks.

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