Part B Insider (Multispecialty) Coding Alert

Published on Tue Jun 19, 2012 PDF

You may have a few less days to make the switch to the 5010 claims format than you thought. CMS's extension of 5010 enforcement ends June 30. But because that day is a Saturday, June 29 is actually the last day you can submit 4010-format claims, CMS explains in a message to providers.

"All claims received after normal close of business cutoff times on June 29, 2012 must be sent as ASC X12 version 5010 or NCPDP D.0," CMS instructs. "Any Medicare FFS claims received in version 4010 format after normal close of business on June 29 will be rejected back to the submitter."

Don't forget that remittance advices need to be transitioned as well. You may have switched your claim files and forgotten your remits, warns MAC CGS Medicare in a message to providers. "Your MAC cannot move your remits to 5010 unless you instruct them to do so," CGS emphasizes.

A breather: You do have some extra time to make the remittance advice switch, however. "During the transition period Medicare FFS experienced issues with the Remittance Advice (835)," CMS says. "Therefore Medicare FFS will be allowing an additional 30 days to complete the 835 transition." Stay tuned for cutoff date announcements.