HIPAA Version 5010

The Centers for Medicare & Medicaid Services (CMS) has mandated conversion to, and implementation of, HIPAA version 5010 by January 1, 2012. HIPAA version 5010, often referred to as ANSI 5010, will replace the current version 4010A1.

HIPAA 5010 is the next step towards implementing administrative simplification between healthcare providers, payers, and business associates. HIPAA 5010 paves the way for further standardization which will provide trading partners better communication and more efficient, less expensive business processes.

One major functional change regarding the conversion is that HIPAA 5010 will support ICD-10-CM diagnosis codes. Under the current 4010A1 format, there is no way to send an ICD-10 diagnosis code in any of the 4010A1 transactions. HIPAA 5010 will be able to support ICD-9 codes, ICD-10 codes, or both. This is especially important in light of CMS’ October 1, 2013 deadline for the switch from ICD-9 to ICD-10-CM diagnosis codes.

With this is mind, ADVOCATE has taken the appropriate measures and is ready for full and complete implementation of HIPAA version 5010 by the January 1, 2012 deadline. Moreover, ADVOCATE’S systems will comply with the timelines established by the DHHS for processing both ANSI 5010 and the ICD-10 code sets.

With best regards,
Kirk Reinitz, CPA