Posts Tagged ‘5010’

Planning for ICD-10: Working with Clearinghouses and Billing Services

November 30, 2012

All claims for health care services provided on or after October 1, 2014, must contain ICD-10 codes. As you prepare for the ICD-10 transition, contact any third-party billing services that you use to make sure they are actively planning for ICD-10.

As you reach out to your clearinghouse or billing service, you may want to ask… (more…)

Deadline for Enforcing HIPAA Version 5010 is Tomorrow!

June 29, 2012

The delay in enforcing the HIPAA version 5010 end on June 30, 2012 for all Medicare providers. Providers not compliant by June 30 will be penalized after the new requirement goes into effect on July 1. If your agency is not yet compliant, or are not sure if you are, you need to take immediate action to avoid disruption in payments.

If your agency is not yet compliant, start by contacting your software vendor to see what you need to do. If you are all set with your software, reach out to your clearinghouse. The good news is that most clearinghouses are now submitting using the 5010 format, but you should make sure your claims are uploading correctly and that they are fully 5010-compliant. (more…)

Mark Your Calendars: Palmetto GBA to Host Four Ask-the-Contractor Teleconferences with Providers

June 28, 2012

Palmetto GBA has announced it will present four Ask-the-Contractor teleconferences between July and April 2013 for Medicare-certified home health providers.

The four specialty topics discussed are Version 5010 (July 10), appeals (October 9), medical review documentation (January 8) and provider enrollment and validation (April 9). (more…)

2012 Conference Preview: On a Clear Day I Can See ICD-10 . . . Or Can I?

June 25, 2012

By Sparkle Sparks,
OASIS Answers

Join Sparkle at conference for “Prep for ICD-10-CM for Home Health Agencies” on July 26. She will also co-present Blueprint for OASIS-C Accuracy on July 22-23. Click here to check out the session summary in the conference brochure!

Following the continuing saga of the implementation of ICD-10 is like playing a game of “red light, green light.” Remember that? Someone yelled “green light” and frantic motion was set in high gear. Then someone yelled “red light” and you had to freeze, no matter how uncomfortable and hard to maintain your position was. If you inadvertently moved, you were out of the game. (more…)

Enforcement Discretion Period for Version 5010 HIPAA Transaction Standards Ends on June 30th

June 21, 2012

The CMS Office of E-Health Standards and Services (OESS) Version 5010 enforcement discretion period ends on June 30, 2012.

Covered entities are required to comply with the updated transactions standards adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA): ASC X12 Version 5010 and NCPDP Versions D.0 and 3.0. (more…)

Medicare Fee-For-Service to Reject Version 4010 Electronic Transactions July 1, 2012

June 7, 2012

Effective July 1, 2012 only ASC X12 Version 5010 (Version 5010) or NCPDP Telecom D.0 (NCPDP D.0) formats will be accepted by Medicare Fee-For-Service. Providers that are still conducting one or more of the Version 4010 transactions electronically, such as submitting a claim or checking claim status, or rely on a software vendor, billing service or clearinghouse to do this on their behalf, are affected by this change. Now is the time to contact your software vendor, billing service or clearinghouse, when applicable, if you have not done so already to ensure you are ready. Transactions conducted by Medicare Administrative Contractor (MAC), fiscal intermediary (FI) or carrier telephone interactive voice response (IVR) systems, Direct Data Entry (DDE) and Internet Portals, for those contractors with Internet Portals, are not impacted. (more…)

How to Avoid Common Version 5010 Claims Rejections

May 24, 2012

The deadline for the Version 5010 upgrade was January 1, 2012, and the enforcement discretion period for all HIPAA-covered entities to complete their upgrade to the Version 5010 electronic standards ends on June 30, 2012. The Version 5010 transaction standards have different requirements than those of Version 4010 and 4010A. There are a few things to keep in mind for processing your Version 5010 claims, which should help avoid unnecessary rejections: (more…)

CMS to Host National Provide Call on HIPAA Version 5010 Implementation

April 16, 2012

CMS is hosting a National Provider Call on Wednesday, April 25 regarding the current status of Medicare FFS implementation of HIPAA Version 5010 and D.0. This National Provider Call focuses on addressing the current 5010/D.0 metrics, addressing recommendations made by Medicare FFS, as well possible outstanding fixes impacting the Part A and Part B Version 5010 transition. The call will begin at 2:00pm ET and end at 3:30pm. (more…)

HHS Secretary Kathleen Sebelius Announces Delay of ICD-10 until October 1, 2014

April 10, 2012

In a new press release from HHS, Secretary Kathleen Sebelius announced a proposed rule that would delay the compliance date for ICD-10 from October 1, 2013 to October 1, 2014. (more…)

ICD-10: It’s Closer Than It Seems! Guidance on Troubleshooting Claims Submissions for Version 5010

April 5, 2012

Although the Version 5010 upgrade deadline was Sunday, January 1, 2012, CMS recently extended their enforcement discretion period for the Version 5010 upgrade for all HIPAA-covered entities for an additional three months, through Saturday, June 30. It’s important that all HIPAA-covered entities continue to take the necessary steps to complete the upgrade to Version 5010 as soon as possible. (more…)