<p> HIPAA 5010 is Coming</p><p>The electronic transmission of specific healthcare transactions starting January 1st, 2012 now has a new standard. The new HIPAA 5010 file format must now be used for the electronic submission of both professional and institutional claims (837), eligibility (270/271), claim status (276/277), remittances (835) and other healthcare transactions.</p><p>Software companies whose packages submit claims and other healthcare related transactions to a clearing house may not be immediately affected by the new 5010 standards going into effect on January 1st, 2012. This is because many clearing houses plan to convert print image and other legacy file formats to the 5010 format well beyond this deadline. For example, our CarePoint Outpatient Rehab Management Software submits electronic claims and other transactions to the Gateway EDI clearing house. They will be converting these healthcare transactions to the 5010 format for us.</p><p>It’s imperative that companies confirm that they can transition to the 5010 standards by the January 2012 compliance date, and make appropriate and timely decisions to do so. This includes being able to handle the new ICD-10 code sets, which is scheduled to be implemented in the fall of 2013.</p><p>The Centers for Medicare & Medicaid Services (CMS) web-site states…</p><p>“ICD-10 codes must be used on all HIPAA transactions, including outpatient claims with dates of service, and inpatient claims with dates of discharge on and after October 1, 2013. Otherwise, your claims and other transactions may be rejected, and you will need to resubmit them with the ICD-10 codes. This could result in delays and may impact your reimbursements, so it is important to start now to prepare for the changeover to ICD-10 codes.”</p><p>ICD-9 Format ICD-10 Format 1•3 -7 characters •3 -5 characters 1 2•Character 1 is alpha 2•First character is numeric or alpha 3•Character 2 is numeric 4•Characters 3 -7 are alpha or numeric 3•Characters 2-5 are numeric 5•Use of decimal after 3 characters 6•Use of dummy placeholder “x” •Always at least 3 characters 4 •Alpha characters are not case-sensitive 5•Use of decimal after 3 characters Our software already accommodates the ICD-10 format because our diagnoses table on the CarePoint database allows for 7 characters. The new ICD-10 codes simply need to be uploaded to this table for our clients when the regulations become effective.</p><p>Visit our web-site carepointsoftware.com to learn more about these changes, and how the CarePoint Rehab Management Software has addressed them. </p>