PNT Data can currently accept and process ICD-10 test files. We will provide 999s and rejection reports, where applicable, in the same process as production claim files.
The ability to complete end-to-end testing is payer dependent. For more information on payer availability, please click here.
What Does My Test File Need in Order to be Accepted?
- ICD-10 test files must have an ISA08 (Receiver ID) value of PNTICD10TESTING.
- Service lines with service dates of 02/01/2013 and later will be expected to use ICD-10 codes.
- Service lines with earlier service dates are required to use ICD-9 codes.
The files are validated to payer specifications with ICD-10 activated based on the 02/01/2013 date. Payer SNIP levels may vary.
When you are ready to send an ICD-10 test file, please email us at firstname.lastname@example.org.
Will I receive any reports for my test file?
Yes, you will receive PNT Data 999s and HTML summary reports; the same as you receive for production files.
Where should I send my test file?
You should send it to the same place as you send your production files.
Do I need to use the “T” indicator in the ISA15?
No, that is not necessary.
Can I mix ICD-9 and ICD-10 claims on the same test file?
Yes, you can mix ICD-9 and ICD-10 claims on the same test file. Dates of Service prior to 02/01/2013 should use an ICD-9 code. Dates of Service on or after 02/01/2013 should use an ICD-10 code.
Can I use both ICD-9 and ICD-10 codes on the same claim for test/production?
No, per CMS guidelines this is not allowed.
What should I do when I am ready to send an ICD-10 test file to PNT Data?
Send an email to email@example.com with ICD-10 Test File in the subject line and indicate that you are ready to send.
Can I test my ICD-10 files with the payers that I send claims in for?
The answer differs from payer to payer. Please click here for specific payer information.
After what date should we have ICD-10 codes on our production files?
Dates of Service or Date of Discharge prior to 10/01/2014 should use an ICD-9 code. Dates of Service or Date of Discharge on or after 10/01/2014 must use an ICD-10 code or they will be rejected. It is acceptable to mix ICD-9 and ICD-10 claims on the same file.