Only 3 Days Remain in the Version 5010 Enforcement Discretion Period!

The Version 5010 enforcement discretion period ends on June 30, 2012.

The Version 5010 Enforcement Discretion Period ends this week, on June 30, 2012. All HIPAA-covered entities were required to upgrade to the new ASC X12 Version 5010 (Version 5010) and NCPDP Versions D.0 and 3.0 by January 1, 2012, however the Centers for Medicare & Medicaid Services’ (CMS) initiated an enforcement discretion period to give the industry additional time to upgrade to the new transaction standards.

As of July 1, 2012, all non-compliant entities will be subject to enforcement action under the existing HIPAA transaction and code set enforcement process. Entities still experiencing issues regarding use of the new electronic standards in their transactions should refer to their respective vendor, clearinghouse, payer’s website or provider service department for assistance.

At this point, your Version 5010, D.0 or 3.0 implementation should be complete. However, if you have not yet finalized your upgrade, you should consider the following steps:

  • Reach out to clearinghouses for assistance and take advantage of any 5010 compliant software that may be available from payers
  • Check with payers now to see what plans they will have in place to handle incoming claims
  • Contact financial institutions to establish lines of credit to cover any temporary interruptions in claims reimbursement as a result of not being Version 5010 compliant

For more information regarding the updated standards, please visit the Versions 5010 and D.0 & 3.0 section on the CMS website.
Keep Up to Date on Version 5010 and ICD-10
Please visit the ICD-10 website for the latest news and resources to help you prepare!