CMS Releases 5010 Implementation Reminder

In June, the Centers for Medicare & Medicaid Services (CMS) released an updated and revised document in MLN Matters regarding the enforcement of the Health Insurance Portability and Accountability Act (HIPAA) 5010 transaction standards that became effective July 1, 2012.  As providers know, Medicare (in most instances) requires the use of electronic claims in order for providers to receive Medicare payments; providers must now submit these claims electronically using the Accredited Standards Committee Version 5010.  This MLN Matters document reminds long term care providers that the implementation of HIPAA 5010 presents substantial changes in the content of the data that providers submit with claims, as well as the data available to providers in response to electronic inquiries.  The implementation requires changes to the software systems and perhaps procedures that providers use for billing Medicare and other payers.  Most of these changes have already been implemented by provider’s vendors.  To obtain a copy of the document, click here.