efficientC ICD-10 Update

July 19, 2015

Industry buzz predicts an increase in denial rates of 100-200% after ICD-10 implementation. Few payers have published the edits they will have in place come October 1st. OS inc.'s strategy in anticipation of increased denial rates is to dedicate our entire team to quickly identifying new denials and immediately get to work on preventing them with edits in efficientC.

efficientC Payer Testing Update

Click here to view the ICD-10 testing schedule for efficientC. The schedule shows the level of testing for each payer by date.

The final round of Medicare Part A, Part B and DME testing was completed in July. Commercial and Medicaid testing began in July and extends through August.

CMS Split Billing Guidelines

Many payers will require claims with dates of service spanning the October 1, 2015 implementation date to be split so that services prior to 10/1 are billed separately using ICD-9 codes and services on or after 10/1 are billed using ICD-10 codes.

CMS recently updated the Medicare FFS Claims Processing Guidance for Implementing ICD-10 publication to include a table of guidelines for split billing.


If you have questions on ICD-10 testing or guidelines, contact one of our Claims Analysts via email at

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