On May 15, CMS issued Transmittal 495 in the One-Time Notification Manual, which includes instructions related to deadlines for required system changes for the implementation of the HIPAA 835 transaction standard version 5010. This step is a necessary prelude to the implementation of ICD-10 in 2013.
Fiscal intermediaries, carriers, and Medicare administrative contractors must achieve different levels of compliance by certain dates. Level I compliance means “that a covered entity can demonstrably create and receive compliant transactions, resulting from the compliance of all design/build activities and internal testing,” according to CMS. Level II compliance means that a covered entity “has completed end-to-end testing with each of its trading partners and is able to operate in production mode with the new versions of the standards.”
CMS outlined the following deadlines:
- December 31, 2010: Level I compliance
- December 31, 2011: Level II compliance
- January 1, 2012: All covered entities must be fully compliant by this date
CMS said it will achieve those same levels of compliance by the aforementioned deadlines. The transmittal stated that CMS will allow versions 4010 (the current transaction set) and 5010 for Medicare claims that it processes during the transition period between January 1, 2011 and December 31, 2011.
CMS also released special edition Medlearn Matters article SE0904 that provides an introductory overview of the 5010 code set and states, “The implementation will require changes to the software, systems, and perhaps procedures that you use for billing Medicare and other payers. So it is extremely important that you are aware of these HIPAA changes and plan for their implementation.”
CMS will host a national education conference call for Medicare fee-for-service providers June 9 during which it will address the implmentation of HIPAA version 5010. To register for the call, go to the CMS Web site. CMS will close registration at 2:30 p.m. EST on June 8 or when available space has been filled.
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