5010 Transactions and ICD-10

As 2012 begins, it is important to keep your focus on compliance with Version 5010 and begin to plan for the transition to ICD-10.

The Version 5010 deadline was on January 1, 2012; however, because of the 90-day enforcement discretion period for all HIPAA covered entities upgrading to Version 5010 (ASC X12 Version 5010), the Centers for Medicare & Medicaid Services (CMS) will not initiate enforcement action until April 1, 2012. CMS made this decision based on industry feedback that many organizations and their trading partners were not yet ready to finalize system upgrades to be compliant.

CMS encourages you to continue internal testing as well as external testing of Version 5010 transactions with trading partners to ensure compliance for Version 5010. Although enforcement action will not be taken prior to April 1, 2012, it is important that you continue to move forward to meet Version 5010 requirements as soon as possible. In addition to testing, if you have not yet created a plan for Version 5010, you should do so in order to meet these compliance deadlines.

Remember: Upgrading to Version 5010 is a critical first step for the nationwide transition to ICD-10 that will take place on October 1, 2013. It is important that you finish this process so that you can continue to prepare your organization for the ICD-10 transition. Please see our article on Nov. 29, 2011, on the implementation of ICD-10 for more information.