Medical Billing Forum

General Category => General Questions => Topic started by: DMK on July 07, 2010, 06:41:07 PM

Title: Version 5010 and ICD-10
Post by: DMK on July 07, 2010, 06:41:07 PM
I got a phone call today that's created a bit of a panic in my soul.

It's about Medicare's version 5010 and ICD-10 codes. 

I've been scrambling around trying to find out what EXACTLY this is, how it pertains to my office, my coding, my job....with the usual results.  I can't find any CLEAR terms as to what they're (Medicare) talking about, and exactly how I'm supposed to implement these changes.

We keep getting seminar "scare" tactics, but again, no clear terms.

From what I understand, ICD-10 relates to In Patient procedures only and ICD-9 will still be used for diagnosis in an office setting otherwise.  ICD-10 CLARIFIES surgical body parts??????

5010, I haven't a clue?  Will I have to update my software?  Is it new claim forms?  Is it Medicare only or industry wide?

I am SO looking forward to hearing from all you pros as to what's coming down the pipe so I can quit biting my nails.  I'll play by the rules, as always, but you gotta tell me the rules!!!    ::)

Thank you all in advance for any input.
Title: Re: Version 5010 and ICD-10
Post by: Michele on July 07, 2010, 10:02:08 PM
The ICD 10's will be replacing the ICD 9's.  They are not for in patient procedures only.

As for the 5010:

"As part of the Health Insurance Portability and Accountability Act (HIPAA), the ASC X12N 5010 electronic transaction standards (a.k.a. version 5010) will replace the current ASC X12N 4010A1 version. The 5010 transaction standards address electronic exchange of administrative and financial information between health care providers, health plans, and their clearinghouses for patient care services. The 5010 upgrade is the latest HIPAA transaction standard to emerge from the ASC X12 standards development organization, and is expected to enhance the electronic exchange of information related to electronic claims submission, insurance eligibility inquiry and verification, claim status inquiry and response, electronic remittance advice or payment explanation, treatment authorization, and referrals, etc.

The Center for Medicare and Medicaid Services (CMS) has set Jan. 1, 2012 as the compliance date for the 5010 standards. On or before this date, billing software vendors, clearinghouses, and payers should have implemented this new transaction standard. Dermatology practitioners' staff should contact their practice-management billing software vendors to learn more about their vendor's implementation plans, software testing timeline, and what they will need to do to obtain the appropriate software updates, as well as find out if staff will require additional training. It is important to be in continuous contact with your practice-management billing software vendor to ensure you receive the most up-to-date information about any new software upgrades regarding 5010 standards."

I hope that helps and isn't just more confusing.   ;D
Title: Re: Version 5010 and ICD-10
Post by: DMK on July 08, 2010, 11:05:04 AM
I read the same thing, and it's all Greek!  What exactly does that mean?  Is it merely a software format / clearing house format thing that will just require an upgrade (at a fee I'm sure)? Or are we talking about re-learning a whole new procedure?

It's getting a little troublesome from a provider standpoint when the government keeps mandating changes that cost so much money it's going to put people out of business.  The new EMR requirements are SOOOOOO expensive, and they haven't even accepted one brand of software and the deadline to be compliant is fast approaching.  It's hard to comply, when nothing is accepted!

Sorry for whining, but I HATE IT when it is demanded that changes are made, but we're not easily told how to make the change.  I'm sure, as usual, it will just mean payment delays as we figure it out.  It took me 9 months to change our practice address through Medicare and we almost went bankrupt in the process.  So now I have this to look forward to. 
Title: Re: Version 5010 and ICD-10
Post by: rdmoore2003 on July 08, 2010, 11:25:20 AM
Michelle, Do you thing this date will be postponed for a later date as was done with NPI's?
Title: Re: Version 5010 and ICD-10
Post by: oneround on July 08, 2010, 12:48:58 PM
This link is also helpful.  Just copy and place in your browser.  We begin our implementation almost 1 year ago

Title: Re: Version 5010 and ICD-10
Post by: DMK on July 08, 2010, 01:42:52 PM
Oneround you're AWESOME!! This link finally explained, in English, what it is, and who I need to contact to get compliant!!!!!!  Now I can take that off my list of things to be stressed about!
Title: Re: Version 5010 and ICD-10
Post by: Michele on July 09, 2010, 10:04:33 AM
I would not be surprised if they postpone the deadline, however, the icd 10 system is already being used in England and they have been planning for this for a long time so they may actually make it.  But I do know that the insurance carriers are already dreading this change and they are saying they will not be prepared. I would highly recommend all billers be prepared!

Title: Re: Version 5010 and ICD-10
Post by: PMRNC on July 09, 2010, 10:26:01 AM
Also doctors are being very cavalier about it. If you have clients it's a good idea to prepare them by giving them some resources for training. Billers should also make another pass through their contracts to make sure they are covering themselves for the clients that are NOT getting educated on this. I have been sending clients monthly newsletters with resources so they can have themselves and their staff's up to par.