Be Ready for 5010 July 1, ’12 and ICD-10 Oct. 1, ’14

Two delays announced recently by the Centers for Medicare & Medicaid Services (CMS) give you a little extra time to bring your billing operation to compliance. But don’t veer off course: Be ready for implementation.

Originally expected to be implemented at the beginning of 2012, compliance was extended to April 1. An extension of the penalty-free phase of the 5010 standards to July 1 was then made to accommodate providers and payers that had not successfully tested and implemented the claim guidelines.

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CMS and payers caution providers not to put off compliance with 5010 standards, however, saying the sooner compliance can be attained, the better. June 30 most likely will be the last day before penalties for not correctly using 5010 are imposed.

The same is advised for ICD-10 implementation. Last week, CMS proposed a one-year extension of implementation to Oct. 1 in the Federal Register. Experts advise billers to take advantage of the extra year to learn how ICD-10 will affect their operations, plan for the transition, and begin making changes. This includes working with payers, electronic health record (EHR) vendors, providers, and coders to coordinate activities and develop new processes so revenue flow is uninterrupted. This also may require educating others (especially providers) what billers will need to assure reimbursement under the code set.

The 30-day comment period for this rule is open now, and is an important way to offer your opinion about the proposed ICD-10 compliance date change. You can submit comments in the following ways:

  • Electronically, by following the ”Submit a comment” instructions on the Regulations.gov website
  • Send a letter to:
    Centers for Medicare & Medicaid Services
    Department of Health & Human Services
    Attention: CMS–0040–P
    P.O. Box 8013
    Baltimore, MD 21244–8013

More information about the proposed rule can be found in the One-Year Delay of ICD-10 Compliance Date fact sheet, which outlines the background of the ICD-10 compliance date, and highlights provisions of the proposed rule and 5010 standards compliance date.

Even though both dates seem a long way off, AAPC and others encourage you to stay the course and be ready when implementation of 5010 and ICD-10 happen.

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