Posts tagged ‘HIPAA’

June 25, 2012

5010 grace period is approaching

CMS has offered a reminder, and some tips, regarding the 5010 upgrade.

The enforcement discretion period for the 5010 for all HIPAA-covered entities to complete their upgrade to the Version 5010 electronic standards ends June 30, 2012. There are a few things to keep in mind for processing your Version 5010 claims, which should help avoid unnecessary rejections:

  1. ZIP Code: You need to include a complete 9-digit ZIP code for the billing provider and service facility location. You should work with your vendor to make sure that your system captures the full 9-digit ZIP.
  2. Billing Provider Address: You need to use a physical address for your Billing Provider Address. Version 5010 does not allow for use of a PO Box address for either professional or institutional claim formats. You can still use a PO Box, however, as your address for payments and correspondence from payers as long as you report this location as a pay-to address.
  3. National Provider Identifier (NPI): You were previously allowed to report an Employer’s Identification Number (Tax ID) or Social Security Number (SSN) as a primary identifier for the billing provider. For Version 5010 claims, however, you are only allowed to report an NPI as a primary identifier.
November 21, 2011

CMS will enforce 5010 standards in April

The Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services (OESS) will not initiate enforcement action with respect to any HIPAA covered entity non-compliant with the ASC X12 Version 5010 (Version 5010), NCPDP Telecom D.0 (NCPDP D.0) and NCPDP Medicaid Subrogation 3.0 (NCPDP 3.0) standards until 90 days after their January 1, 2012 compliance date, or until March 31, 2012.

The compliance date for implementation of these updated standards remains January 1, 2012.

Look at the Latest News page of the ICD-10 website.

September 8, 2011

Four months to the 5010 conversion

The Version 5010 transition is less than four months away, and your transition should be well under way.

Where are you in your preparedness?

You should:

•     Continue to coordinate the transition to the new formats and testing with providers, clearinghouses, billing services, and other business partners

•     Complete external testing and your Version 5010 transition by December 31, 2011, to achieve Level II compliance

See the CMS 5010 website for more information about Version 5010.

December 7, 2010

Coding education in Vegas does not stay in Vegas!

Go back to your agency as a coder or administrator and share the information you learned at the Coding and Regulatory Symposium! Come to my two-day class focusing on recent coding changes, especially those impacting wounds and therapy, with a focus on regulations and how these changes impact the bottom-line of agencies.

January 27-28, 2011, Monte Carlo Resort and Casino in Las Vegas, Nevada
9:00AM -4:15PM each day

This class is appropriate for all levels of coders, plus administrators who want to learn more about how coding impacts revenues and operations.

Agenda Day 1

Morning focus: Regulatory Issues
9:00‐10:00  How Coding and OASIS Add to Your Case Mix Score
10:00‐10:45  Myths and Truths that Impact Therapy Coding
10:45‐11:00 Break
11:00‐11:30 Common Errors Impacting Your Payment and Outcomes
11:30‐12:00 ICD‐10 and the 2011 Change to the 5010 Format
12:00‐1:00 Lunch
Afternoon focus: Applying regulatory education to coding
1:00‐2:00  Sequencing and Coding Guidelines
2:00‐2:45  Interactive Coding Session
2:45‐3:00 Break
3:00‐4:15 Interactive Coding Session (continued)
4:15  Adjournment
Agenda Day 2
9:00‐10:30 Wound Care Coding: All Wrapped Up
10:30‐10:45 Break
10:45‐12:00 Interactive Coding Session
12:00‐1:00 Lunch
1:00‐2:30 How Jan. 1 PPS Changes Impact your Operations
2:30‐2:45 Break
2:45‐3:30 How to Support Your Coding and Appeal Downcoding
3:30‐4:15 Facts and Forward Thinking about ICD‐10‐CM and ICD‐10‐PCS
4:15 Adjournment

Coming to Vegas?

$49 a night! That’s the price we have arranged (plus $12.95 for a resort fee) for each night at the Monte Carlo!!

Looking for a registration form?