CMS releases final 2015 post-ICD-10 metrics: 5 findings

Although ICD-10 was once considered the Y2K of the healthcare industry, the coding update came and went with relatively little noise, and relatively unchanged rates of claims denials, according to CMS.


CMS released its final 2015 ICD-10 Medicare claims data Thursday, which compared claims data from the fourth quarter of 2015 to historical baseline figures. According to the data, claims denials and submissions post-ICD-10 deviated very little from historical benchmarks.


On CMS' blog, the organization attributed much of ICD-10's success to its own efforts in physician-facing, collaborative and education-focused coding initiatives.


"The ICD-10 implementation had all the hallmarks of how CMS could drive a successful implementation and aim for excellence," said CMS acting administrator Andy Slavitt on the organization's blog.


Below are five data findings.


1. According to CMS, 4.6 million Medicare claims were submitted each day during the fourth quarter of 2015. This perfectly matched the historical submission benchmark.


2. Approximately 1.9 percent of total claims submitted were rejected in the fourth quarter of 2015, compared to a historical rejected benchmark of 2 percent. 


3. In the fourth quarter, 0.07 percent of total ICD-10 claims submitted were rejected.


4. In the fourth quarter, 0.07 percent of total ICD-9 claims submitted were rejected, compared to a historical benchmark rate of 0.17 percent.


5. In the fourth quarter of last year 9.9 percent of total claims processed were denied, compared to a historical denial benchmark of 10 percent.


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