CMS Begins Version 5010 Testing

If you receive the Centers for Medicare & Medicaid Services (CMS) Transmittals in your e-mail inbox, you already know that Version 5010 testing is well underway.

Version 5010 implementation policy is part of the Health Insurance Reform modifications to Health Insurance Portability and Accountability Act (HIPAA) final rules published in the Federal Register on Jan. 16, 2009 by the U.S. Department of Health and Human Services (HHS), 45 CFR Part 162.

Existing standards (ASC X12 4010A1 and NCPDP 5.1) will be replaced with the new standards (5010 and D.0). In accordance with HIPAA standards, Version 5010 will allow for reporting the extra digits required for ICD-10-CM code system implementation, which is scheduled for Oct. 13, 2013.

Some important dates in the Version 5010 implementation process are:

  • Effective Date of regulation: March 17, 2009
  • Level I compliance by: Dec. 31, 2010
  • Level II Compliance by: Dec. 31, 2011
  • All covered entities have to be fully compliant on: Jan. 1, 2012

Level I compliance means “that a covered entity can demonstrate that it could create and receive compliant transactions, resulting from the compliance of all design/build activities and internal testing.”

Level II compliance means “that a covered entity has completed end-to-end testing with each of its trading partners, and is able to operate in production mode with the new versions of the standards.”

Testing of 5010 CRs

STC Beta testing and Medicare Administrative Contractors (MAC) UAT testing of 5010 implemented change requests (CRs) from October 2008’s quarterly release through April 2010’s quarterly release, will begin in May 2010. Testing activities will be initiated based on the availability of 5010 test data (Parts A, B, and Durable Medical Equipment (DME)), PC Ace software, and the Common Edits and Enhancements Module (CEM).

The CMS projected timeline relating to this testing is:

  • April or May – CEM is available to STC and to Part A and Part B (Part A/B) MACs
  • May – STC begins Beta testing 5010 CRs using the April release of FISS, MCS, and VMS
  • May – MACs begin installing CEM in their Local Data Centers (LDCs) – see CR 6836, Transmittal 647, dated March 5
  • May/July – MACs begin UAT testing of 5010 CRs when CEM is available for use in their LDC
  • July – STC continues Beta testing 5010 CRs, using the July release of FISS, MCS, and VMS
  • May to Oct – MACs will UAT test 5010 CRs, using the April shared system release in May and June, and using the July shared systems release from July to October, with all UAT testing of 5010 CRs listed in CR 6739 completed by October 2010

The STC will test the CRs on the attached schedule in CR 6739 (see Excel spreadsheet, “STC Testing Schedule.xls”). Effective July 1, the first portion of the CRs listed in STC Testing Schedule.xls will be tested and effective Oct. 1, the second portion of the CRs listed will be tested. Note: Not all CRs apply to all Shared Systems nor impact MACs, so refer to the STC schedule in CR 6739 to verify if a particular CR is applicable to you.

VMS Tests for HIPAA 5010

The ViPs Medicare System (VMS) shared system maintainer is testing end-to-end HIPAA 5010 changes and interfaces to assure all changes are made correctly. Implementation date is July 6.

For more on VMS testing see CMS’ CR 6853.

Beta Testing Begins for CEM at Part A/B MAC Local Data Centers

Selected Part A and Part B MACs will perform Beta testing of the v5010 CEM at their local data centers with Part A and Part B CEM developers. Implementation date is April 30.

CR 6872 provides direction and support for the Beta testing of the Version 5010 CEM at the local data centers of three selected Part A/B MACs. MAC jurisdictions J1, J13, and J14 were selected to participate in Part A/B CEM Beta testing. Beta testing by these MACs is in conjunction with the Part A and Part B CEM developers, Pinnacle and Hewlett Packard (HP). Beta testing is scheduled for March 22 through April 18.

Catch-up Phase Two – MAC Jurisdiction 9 Only

CMS, in CR 6847, instructs Jurisdiction 9 (J9)  to proceed with the second phases to prepare their systems to process ASC X12 Version 005010 transactions. Previously issued CRs 6475, 6476, 6575, 6589, 6597, and 6676 addressed J1, J3, J4, J5, J10, J12, J13, J14, and the Common Electronic Data Interchange (CEDI) Contractor. J2, J6, J7, J8, J11, and J15 are not affected by this CR 6847 and a future CR will be issued addressing these MAC jurisdictions.

Previously issued transmittals can be used for phase two catch-up:

  • Transmittal-R518OTN, CR 6475, issued July 17, 2009
  • Transmittal-R516OTN, CR 6476, issued July 17, 2009
  • Transmittal-R579OTN, CR 6575, issued Oct. 19, 2009
  • Transmittal-R550OTN, CR 6589, issued Sept. 04, 2009
  • Transmittal-R537OTN, CR 6597, issued Aug. 21, 2009
  • Transmittal-R605OTN, CR 6676, Issued Nov. 27, 2009

CMS is making changes and updates daily about Version 5010 testing and implementation. To keep abreast, visit the CMS 2010 Transmittals webpage often.

For more on Version 5010 and what it means to ICD-10-CM implementation, read “Version 5010: More Than a Software Update” on page 44 of April’s Coding Edge magazine.

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One Response to “CMS Begins Version 5010 Testing”

  1. Karen Zook says:

    Has anyone seen a slow down in payments due to this implementation?

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