ICD-10 & 5010 Preparedness
Educate – Communicate – Execute
Beginning on January 1, 2012, a federal mandate requires health plans, clearinghouses and providers to use the new 5010 Electronic Transaction Standards to share healthcare data including claims, remittance, eligibility and claims status requests and responses. In addition, the 5010 transaction becomes the foundation for the next major industry shift to the ICD-10 code set with compliance due by October 1, 2013.
As your trusted partner, MPV is dedicated to ensuring the success of the 5010 and ICD-10 transitions. MPV takes seriously the changes that affect the healthcare industry and has implemented an internal 5010 task force to monitor the changes, prepare products and services, and communicate with clients.
Much like providers, MPV solutions are dependent on the compliance of the healthcare trading partners and entities with which data is exchanged and stored. Working in coordination with clients and trading partners, MPV is set to meet the compliance mandates within the expected timeframes.
Ongoing communications with clients, payers and third-party vendors via email, telephone and survey methods will ensure information gets to the right people at the right time to meet all deadlines.
If you have specific questions about how HIPAA 5010 or the ICD-10 changes affect MPV products or services, please contact our 5010 task force at 5010info@mpv.com.
What is HIPAA 5010?
In January 2009, the Department of Health and Human Services (HHS) announced a final rule that replaces the current version of the electronic transaction standards (4010) with version 5010 for all electronic claim remittance and eligibility transactions. All transactions must be transmitted in compliance with standards set forth by HIPAA (Health Insurance Portability and Accountability Act) and HHS by the final compliance date of Jan 1, 2012.
What is ICD-10?
HHS announced on August 15, 2008, a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report healthcare diagnoses and procedures with greatly expanded ICD-10-CM (diagnosis) and ICD-10-PCS (hospital procedure) code sets. In a separate proposed regulation, HHS has proposed adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as healthcare claims. Version 5010 is essential to use of the ICD-10 codes. ICD-10 compliance is expected by Oct. 1, 2013.
To learn more about these regulations, visit CMS at http://www.cms.gov/home/regsguidance.asp.
