Pathology/Lab Coding Alert

Compliance, payment, and ICD-10 hang in the balance.Say goodbye to forms 4010/4010A1 for electronic transactions starting Jan. 1, 2012. That's the date your clinical laboratory or pathology group will need fully functional form 5010 to comply with the Health Insurance Portability & Accountability Act of 1996 (HIPAA) electronic transaction standards. If you don't have your 5010 glitches worked out by that date, you won't be able to submit electronic transactions to Medicare. Get Ready for ICD-10Version 5010 lays out the technical electronic standards mandated for HIPAA transactions -- that includes claims, eligibility inquiries, remittance advice, and payment data using ICD-10. The current version -- 4010/4010A1 -- does not accommodate the ICD-10 code set. That's why CMS will require version 5010 for use by all HIPAA-covered entities (providers, health plans, clearinghouses, and their business associates, including billing agents) as of Jan. 1, 2012. Timeline: CMS began accepting 5010 forms effective Jan. 1, 2011, and [...]