Ingenix Survey: We Are Not 5010 Prepared Yet

Conversion to the ASC X12 version 5010 architecture, mandated by the Health Insurance Portability and Accountability Act (HIPAA), is a reality. The apparent opinion of many payers and providers, however, is that it is but a dream.

According to a recent Ingenix survey, only 46 percent of hospitals and providers say they have begun to assess the impact of 5010 conversion. Physicians lag behind, with 58 percent admitting they haven’t begun to prepare.

Ambulatory Surgical Center CASCC

According to Ingenix Managing Consultant Larry Watkins, providers and payers may be in for “a rude awakening” when they realize just how little time they have to prepare (Ingenix Innovations, Nov. 17).

Although the compliance date is two years away (Jan. 1, 2012), the Level 1 testing date is only a year away (Dec. 31, 2010).

“To meet this deadline, payers and providers really must begin their 5010 design build today and conduct internal testing throughout 2010,” Watkins said. Level 2 testing must be completed by Dec. 31, 2011.

Note: Small health plans have until Jan. 1, 2013 for 5010 compliance.

Angela Boynton, RHIT, CPC, CCS, CPC-H, CCS-P, CPC-P, CPC-I, recently wrote an article for the AAPC regarding 5010. She said, “The transition to 5010 is a vital step in the path to successful ICD-10 implementation. The 5010 architecture increases the field size for diagnostic codes to accommodate the longer ICD-10 code structure. Simply put, if 5010 fails, ICD-10 will fail.”

The Centers for Medicare & Medicaid Services (CMS) held a conference call on 5010 implementation earlier this year. Read the main points that came out of this 5010 presentation.


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