5010 – After June 30, 2012
What is 5010?
On January 16, 2009, the Secretary of the Department of Health and Human Services (DHHS) adopted the Accredited Standards Committee X12 Version 5010 as the next Health Insurance Portability and Accountability Act (HIPAA) standard for HIPAA-covered transactions (replacing Version 4010). Examples of affected HIPAA transactions include electronic claims and remittance advice.
- The Centers for Medicare & Medicaid Services (CMS) announced on March 15, 2012, that it would not initiate enforcement of 5010 until after June 30, 2012. This is a 3-month extension from the original enforcement date of April 1, 2012.
- For further information on 5010 enforcement, refer to the following:
What must you do to prepare?
- Talk with your practice management system vendors about their preparation for Version 5010.
- What updates are they planning to your system for Version 5010?
- When do they expect to have it ready to be installed?
- Check your contract to see if upgrades are included as part of your agreement.
- Discuss implementation plans with all your clearinghouses, billing services, and payers to ensure a smooth transition.
- Be proactive.
- Ask when they will be ready to test their systems for transition.
- Identify potential changes to workflow and business processes.
- Conduct test transactions using Version 5010 with your clearinghouse.