Earn CEUs Thru v5010 Readiness Call
The Centers for Medicare & Medicaid Services (CMS) will host its 15th national education call regarding Medicare fee-for-service’s implementation of Health Insurance Portability and Accountability Act (HIPAA) Version 5010 and D.0 transaction standards on March 30. This is an opportunity to learn how to meet this essential requirement. And as a bonus, participating coders may qualify to earn a Continuing Education Unit (CEU) from AAPC.
This session will focus on provider testing and readiness. The mandatory switch to the new version 5010 of the X12 standards for HIPAA transactions is less than a year away. Is your practice ready? Prior to the Jan. 1, 2012 compliance date, health care providers must produce accurate electronic test claims. Testing with Version 5010A1 errata begins in April.
Specifically, all submitters must send a test file containing at least 25 claims, which are representative of their practice or services. Test claims are subject to standard syntax and Implementation Guide (IG) semantic data edits.
- Standard syntax testing validates the programming of the incoming file and includes file layout, record sequencing, balancing, alpha-numeric/numeric/date file conventions, field values, and relational edits. Test files must pass 100 percent of the standard syntax edits before production is approved.
- IG Semantic Data testing validates data required for claims processing, e.g., procedure, diagnosis codes, and modifiers. A submitter must demonstrate, at a minimum, a 95 percent accuracy rate in data testing before production is approved. For fiscal intermediaries (FIs), the minimum 95 percent accuracy rate includes the front-end edits applied using the Fiscal Intermediary Shared System (FISS) implementation guide-editing module.
Find out what else you need to know to submit Version 5010 Medicare files electronically to your Medicare administrative contractor (MAC) next year. Registration for the CMS education call will close at 2 p.m. EST on March 29, or when available space has been filled.
Note that you can submit a question related to this topic at any time by e-mailing your inquiry to the CMS 5010 Fee-for-Service (FFS) information resource at 5010FFSInfo@cms.hhs.gov.
Continuing Education Credits
AAPC members will be awarded one CEU per hour of participation in this CMS National Provider Conference Call. AAPC will accept your e-mailed confirmation and call description as proof of participation.