ICD-10 Readiness

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 support@pntdata.com.

Questions

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 support@pntdata.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.

Contact Us

 
Notice to Payers
PNT Data is available at this time for payer organizations wishing to conduct end-to-end testing with providers and vendors. We have successfully tested with several of the nation’s leading payers. Learn more...

Tests include:
  • Receipt of both ICD-10 and ICD-9 coded test claims
  • Confirmation of accept/reject logic based on date of service or discharge
  • Routing of claims
  • Processing and payment of both ICD-10 and ICD-9 on claim processing engines
  • Return of 999, 277, and 835 standard transactions
  • Ability to validate at SNIP Levels 1-5 (for testing purposes only)
PNT Data has provider clients available for testing purposes. For questions regarding how to begin, please contact Mike Knowles today by phone at 860. 257.2030 or by email at mikeknowles@pntdata.com