With the Version 5010 compliance date – Jan. 1, 2012 – on its way, the Centers for Medicare & Medicaid Services (CMS) have planned a National Version 5010 Testing Week for Aug. 22-26.
A CMS bulletin about the event called Testing Week “an opportunity for trading partners to come together and test compliance efforts that are already underway with the added benefit of real-time help desk support and direct and immediate access to the MACs.”
CMS held a National Testing Day on June 15 and said afterward, “There were no significant error scenarios reported.”
Version 5010 is the new version of the X12 standards for HIPAA transactions. Health plans, healthcare clearinghouses and certain healthcare providers must use Version 5010 when conducting electronic transactions, including claims, eligibility inquiries and remittance advices. Version 5010 replaces the currently used 4010A1 version.
A CMS Web site on the 5010 transitions says, “The current versions of the standards are widely recognized as lacking certain functionality that the healthcare industry needs.”
Among the improved functions of Version 5010 is its accommodation of the new ICD-10 codes used for medical diagnosis.
The CMS ICD-10 Web site says, “If providers do not conduct electronic health transactions using Version 5010 as of Jan. 1, 2012, delays in claim reimbursement may result.” Another portion of the site says that starting Jan. 1, 2012, “Version 4010 claims are no longer accepted.”
ICD-10 codes, which replace the current ICD-9 codes, need to be used on claims for service provided on or after Oct. 1, 2013.
