CIPROMS has submitted the first few claims for October 2015 dates of service with ICD-10 codes, and so far, the results have been positive.
- Most of the claims have passed various levels of claims edits and are now pending with the payer.
- A small percentage of claims (< 3 percent) were flagged appropriately in the claims edit process, and CIPROMS is working with clients to ensure proper coding.
- A few edits are being disputed with our claims scrubber provider. Those codes are being confirmed by our certified coding team and then scrubbed clean so they can be processed. However, CIPROMS will work to ensure those edits are corrected to avoid future delays.
- One Anthem claim has been processed and adjudicated for payment by the payer.
Our coders continue to follow the code, audit, and educate plan, informing both the coding team and clients how to improve code selection and documentation.
We will continue to report on the successes and challenges with the ICD-10 implementation. CIPROMS clients will hear directly from their assigned account executive if any issues directly affect their claims.
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