All Entries Tagged With: "5010"
Questions to ask your IT team
During a November 17 virtual meeting hosted by the American Health Information Management Association (AHIMA), co-presenter Laurine Johnson, MS, RHIA, CPC-H, director of HIM services at Ingenix, gave the following list of questions you should ask your information technology (IT) team to prepare for ICD-10 implementation:
- How does 5010 impact my ICD-10 implementation?
- Which databases contain ICD-9-CM codes?
- Which software packages include ICD-9-CM codes?
- Which interfaces include ICD-9-CM?
- What reports contain ICD-9-CM codes?
- How does ICD-10 impact my electronic health record?
- How many vendors are involved with the software, databases, connectivity, and interfaces?
- What are the vendor plans for implementing ICD-10 and how does it impact this organization?
- Should we convert data from ICD-9-CM to ICD-10? Should we convert ICD-10 data to ICD-9-CM codes?
- Does software need to be upgraded or replaced?
- What will be the capital and operating budget impact?
- What is the testing plan?
Have you already consulted with your IT team regarding ICD-10 implementation? Are there other questions you would add to this list? Were you surprised to hear any of the answers your IT team provided? Share your feedback, and post a comment!
Register for CMS education call on HIPAA Version 5010
CMS will host its third national Medicare fee-for-service (FFS) education call on HIPAA Version 5010 on September 9, from 2 p.m. to 3:30 p.m. Providers will need to transition to this new transaction standard to be ready for ICD-10 implementation in 2013. Learn more about this vital switch to HIPAA Version 5010 by accessing a recent JustCoding.com story.
The presentation will cover:
- Medicare FFS error handling transactions (TA1, 999, and 277CA)
- Planned use of each transaction
- Applicable rules and exceptions for the Medicare FFS program
It’s important to note that this presentation is geared toward billing software programmers or developers that reside within provider organizations. So if you’re a medical coder or HIM staff member, it’s important that you pass this information along to your IT department.
You must register for the call. If you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation.
To register for the call participants need to:
- Go to http://www2.eventsvc.com/palmettogba/090909
- Fill in all required data
- Verify your time zone is displayed correctly the drop down box
- Click “Register”
You will be redirected to the “Thank you for registering” page and will receive a confirmation e-mail shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation e-mails.
A few days prior to the call, check the Educational Resources page on CMS’ 5010 Web page to obtain a copy of the presentation that will be used during the call. Participants will have an opportunity to ask CMS experts questions during a Q&A session following the presentation.
Registration will close at 2 p.m. ET on September 8 or when available space has been filled.
Transaction standard 5010’s vital role in switch to ICD-10: Check out new CMS Web site
Although the health care community is primarily focusing on the implementation to ICD-10 in 2013, a critical step before the new coding system takes effect is the switch to transaction standard version 5010. On July 17, CMS launched a Web site that includes information about HIPAA transaction standard version 5010, which providers must implement by January 1, 2012.
The new CMS Web site also includes information related to:
- Version D.0: The new version of the National Council for Prescription Drug Program (NCPDP) standards for pharmacy and supplier transactions
- Version 3.0: A new NCPDP standard for Medicaid pharmacy subrogation
It also includes a link to an FAQ that addresses many common questions related to the new 5010 transaction standard.
On June 9, CMS hosted a national education conference call for Medicare fee-for-service providers titled, “HIPAA Version 5010 – What you need to know!” that addressed Medicare’s implementation of the new standard. The transition to HIPAA 5010 is a necessary prelude to the implementation of ICD-10 in 2013.
Access a recent JustCoding news brief to learn more about Transmittal 495 in the One-Time Notification Manual, which addresses requirements and deadlines for 5010 implementation.
What steps have you taken to address the move to transaction standard 5010?
The 411 on HIPAA version 5010
One of the many things that will be affected in order to accommodate the ICD-10 codes is the format of electronic claims. CMS recently announced that it receives more than 99% of the Medicare Part A claims and more than 95% of the Part B claims electronically. Today, physicians submit electronic claims to Medicare using Accredited Standards Committee (ASC) X12N Version 4010/4010A1. Because the existing format lacks functionality for certain transactions (e.g., the ICD-10 reporting system), Version 5010/D.0 will eventually replace the current electronic claims version.
Electronic communication between physicians and payers and hospitals requires that we have standardized codes to enable the electronic exchange of certain health information.
Standards exist today for eight electronic transactions and six code sets. The transactions are:
• Health Care Claims or Equivalent Encounter Information
• Eligibility for a Health Plan
• Referral Certification and Authorization
• Health Care Claim Status
• Enrollment and Disenrollment in a Health Plan
• Health Care Payment and Remittance Advice
• Health Plan Premium Payments
• Coordination of Benefits
The code sets are:
• International Classification of Diseases, 9th Edition, Clinical Modification, Volumes 1 and 2
• International Classification of Diseases, 9th Edition, Clinical Modification, Volume 3 Procedures
• National Drug Codes
• Codes on Dental Procedures and Nomenclature
• Health Care Common Procedure Coding System
• Current Procedural Terminology, 4th Edition
The ICD-9 code sets, developed nearly 30 years ago, contain approximately 17,000 codes and can no longer be adequately expanded. The ICD-10 code sets have more than 155,000 codes to accommodate advances in diagnoses and procedures. The ICD-10 and transaction rules have long been expected and must move together, as Version 5010 was designed to be used with the ICD-10 code sets. While Medicare contractors will be ready to handle the new standards and the HIPAA 5010 claim format by January 1, 2011, the compliance date for submitting claims in the new format is not required until January 1, 2012. CMS recently released a Special Edition MedLearn Matters article SE0904 that provides a high-level overview of some of the differences between the two claim formats, with additional resources.
