News Updates | April 9, 2012

HHS Press Release: HHS Secretary Kathleen Sebelius

Announces Delay of ICD-10 until October 1, 2014

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

The ICD-10 compliance date change is part of a proposed rule that would adopt a

standard for a unique health plan identifier (HPID), adopt a data element that would

serve as an “other entity” identifier (OEID), and add a National Provider Identifier

(NPI) requirement. The proposed rule was developed by the Office of E-Health

Standards and Services (OESS) as part of its ongoing role, delegated by HHS, to

establish standards for electronic health care transactions under the Health

Insurance Portability and Accountability Act of 1996 (HIPAA). OESS is part of the

Centers for Medicare & Medicaid Services (CMS).

The full release can be found on the CMS Website, and more information about this

proposed rule can be found on the proposed rule ICD-10 fact sheet. A segment of

the HHS press release is located below.

The Department of Health and Human Services (HHS) today

announced a proposed rule that would establish a unique health plan

identifier (HPID). The change would save the health care industry up

to $4.6 billion over ten years by enabling greater automation of

electronic health care transactions, in turn helping physicians spend

less time interacting with health plans — and more time with patients.

The proposed rule was developed by the Office of E-Health

Standards and Services (OESS),  as part of its ongoing role,

delegated by HHS, to adopt standards for electronic health care

transactions under the Health Insurance Portability and Accountability

Act of 1996 (HIPAA). OESS is part of the Centers for

Medicare & Medicaid Services (CMS).  The proposed rule would

implement several administrative simplification provisions of the

Affordable Care Act.

The proposed rule also would delay by one year, until Oct. 1, 2014,

the date by which covered entities must comply with International

Classification of Diseases, 10th Edition diagnosis and procedure

codes (ICD-10). Covered entities are defined in HIPAA as (1) health

plans, (2) health care clearinghouses, and (3) health care providers

who electronically transmit any health information in connection with a

transaction for which HHS has adopted a standard .

Some provider groups have expressed serious concerns about their

ability to meet the October 1, 2013 compliance date. CMS and HHS

believe the change in the compliance date for ICD-10, as proposed in

this rule, would give providers and other covered entities more time to

prepare and fully test their systems to ensure a smooth and

coordinated transition among all industry segments. 

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, and to download and share the implementation widget today!

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This service is provided to you by the Office of E-Health Standards & Services, ICD-10.

News Updates | March 30, 2012

Guidance on Troubleshooting Claims Submissions for Version 5010

Although the Version 5010 upgrade deadline was January 1, 2012, the Centers for Medicare & Medicaid Services (CMS) recently extended their enforcement discretion period for the Version 5010 upgrade for all HIPAA covered entities for an additional three (3) months, through June 30, 2012. 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.

Recently, some providers have experienced issues with Version 5010 claims processing or payment. CMS has created a fact sheet that provides guidance to help providers troubleshoot some of the difficulties they are experiencing with claims submissions. The fact sheet contains information on:

• How to handle claims that have failed edits during the delivery process
• What providers can do if they have difficulty receiving information from clearinghouses and/or billing vendors
• Links to each of the Medicare Administrative Contractor (MAC) websites, which include lists of their   top 10 edits for Version 5010 claims
• Additional reasons why some providers may receive claims rejections

The MACs will continue to work closely with clearinghouses, billing vendors, and health care providers requiring assistance in submitting and receiving Version 5010 compliant transactions. If any entity is experiencing difficulty reaching a MAC, they should send a message describing their issue to ProviderFeedback@cms.hhs.gov with “5010 Extension” in the subject line.

Make sure to take a look at the Version 5010 section of the ICD-10 website to find helpful fact sheets on

the upgrade to Version 5010 and previous listserv messages discussing the Version 5010 upgrade.

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, and to download

and share the implementation widget today!

Subscriber Services: Manage Preferences | Unsubscribe

This service is provided to you by the Office of E-Health Standards & Services, ICD-10.