Enforcement of 5010 Standards for E-Claims Delayed Again
Enforcement of 5010 Standards for E-Claims Delayed Again
March 15, 2012 — Organized medicine has scored another win in delaying the implementation of federal regulations that it finds problematic for physicians.
Today the Centers for Medicare and Medicaid Services (CMS) announced that it is pushing back the enforcement date for new standards designed to streamline electronic insurance claims from March 31 to June 30. CMS said the 3-month delay will give physicians, insurers, claims clearinghouses, and software vendors more time to switch their billing systems over to the so-called Health Insurance Portability and Accountability Act (HIPAA) Version 5010 standards, which will replace Version 4010.
Medical societies have complained to CMS that many physicians who have attempted to submit electronic Medicare claims under the new standard have not been paid.
CMS said in a press release today that physicians and other affected parties are making "steady progress" in the conversion. The Medicare fee-for-service program is successfully receiving and processing more than 70% of Medicare Part A claims, and more than 90% of Part B claims, in the Version 5010 format. CMS expects this success rate to reach 98% industry wide.
Postponement Comes on Top of ICD-10 Delay
The announcement marks the second Version 5010 postponement in 5 months. The deadline for converting to the new standards had been January 1, 2012, but CMS said last November that it was resetting it for March 31. Technically, the compliance deadline remains January 1; the agency is merely declining to enforce it.
These 2 postponements come on top of a related pushback that organized medicine wrested from CMS regarding a new and expanded set of diagnostic codes called the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, or ICD-10. CMS ordered the switch from the current ICD-9 set to ICD-10 as part of implementing HIPAA. Only Version 5010 standards incorporate the use of ICD-10.
The American Medical Association told CMS that changing to ICD-10, which has roughly 5 times as many diagnostic codes as ICD-9, will strain practice finances and make it harder for physicians to afford electronic health record systems pushed by the government. The association asked CMS to find a simpler replacement for ICD-10, but the agency instead said it would extend the deadline for ICD-10 compliance, which had been October 1, 2013. CMS plans to announce a new compliance date once it has studied the matter.
March 15, 2012 — Organized medicine has scored another win in delaying the implementation of federal regulations that it finds problematic for physicians.
Today the Centers for Medicare and Medicaid Services (CMS) announced that it is pushing back the enforcement date for new standards designed to streamline electronic insurance claims from March 31 to June 30. CMS said the 3-month delay will give physicians, insurers, claims clearinghouses, and software vendors more time to switch their billing systems over to the so-called Health Insurance Portability and Accountability Act (HIPAA) Version 5010 standards, which will replace Version 4010.
Medical societies have complained to CMS that many physicians who have attempted to submit electronic Medicare claims under the new standard have not been paid.
CMS said in a press release today that physicians and other affected parties are making "steady progress" in the conversion. The Medicare fee-for-service program is successfully receiving and processing more than 70% of Medicare Part A claims, and more than 90% of Part B claims, in the Version 5010 format. CMS expects this success rate to reach 98% industry wide.
Postponement Comes on Top of ICD-10 Delay
The announcement marks the second Version 5010 postponement in 5 months. The deadline for converting to the new standards had been January 1, 2012, but CMS said last November that it was resetting it for March 31. Technically, the compliance deadline remains January 1; the agency is merely declining to enforce it.
These 2 postponements come on top of a related pushback that organized medicine wrested from CMS regarding a new and expanded set of diagnostic codes called the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, or ICD-10. CMS ordered the switch from the current ICD-9 set to ICD-10 as part of implementing HIPAA. Only Version 5010 standards incorporate the use of ICD-10.
The American Medical Association told CMS that changing to ICD-10, which has roughly 5 times as many diagnostic codes as ICD-9, will strain practice finances and make it harder for physicians to afford electronic health record systems pushed by the government. The association asked CMS to find a simpler replacement for ICD-10, but the agency instead said it would extend the deadline for ICD-10 compliance, which had been October 1, 2013. CMS plans to announce a new compliance date once it has studied the matter.
Source...