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Thread: 5010

  1. #1

    Post 5010

    AAPC: Back to School
    Hey there!
    Our office has verbally been advised several things about 5010 that do not seem correct to me. First, we were advised that in box 33-billing provider information that we can no longer use a PO box as the address but have to use a physical address which does not sound right to me. Next, we were advised that our EMR is not doing anything to prepare for 5010 because the EDI clearinghouse will make all the necessary changes for us prior to claims submission for years to come which again does not sound right to me. Lastly, if the above is correct and our EMR does not do anything to prepare for 5010 then when we submit paper claims they will remain in the 4010A1 format and it seems we will have issues with the payers at that time.
    Can anyone provide some places where documentation states the above questions are correct or not correct so I can take that information to the appropriate people.


    Kim, CPC

  2. #2
    Join Date
    Apr 2007


    You can not use PO box, that is right. But the rest is wrong. You EPM needs to be prepared for 5010. You clearinghouse can not do what you suppose to do. You need to change couple of things like zip codes (they should be 9 digits now). What kind of practice managemnt software do you use?

  3. #3
    Join Date
    Apr 2007
    Coastal Coders


    9 digit zip codes are going to be an issue

  4. #4
    Join Date
    Apr 2007


    Quote Originally Posted by Oceanlivin View Post
    9 digit zip codes are going to be an issue
    actually its not that hard. Our PM system is laready tested for 5010 and it took me probably about an hour or two to fix zip codes.

  5. #5


    Your clearinghouse may be able to convert your 4010 claims into 5010 format - but it may cost you to have them do 'custom fixes' for your claims.

    Even if they aren't changing anything for January 2012, your practice management software still has to be prepared to integrate the alpha-numeric ICD-10 codes by October '13.

  6. #6


    Our practice has been aggressively testing 5010 in our developement software prior to going live. We ran our test claims through our clearinghouse to verify 5010 compliance. This gave us the oppertunity to check/verify group and sub group NPI linkage, taxonomy codes and so on. You may notice other areas that need to be updated. My mindset is that, my clearinghouse is only as good as the information I give it.

  7. #7


    Our EMR is also not doing anything for 5010. We just upgraded to the newest version which is tied into our clearinghouse that will convert all of the information to 5010. Our software said that it would take an extraordinary amount of time to try and reconfigure everthing with in the system and felt that the clearinghouse option was the most efficient. I am not sure about the paper formating to a 4010A1. I will ask though as we would have the same issue.

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