Although we live in uncertain times, one thing is certain: Medical practices have a lot of changes coming their way. Meaningful use, ICD-10, and HIPAA 5010 will change the medical landscape. Each of them are important, but HIPAA 5010 requires your immediate attention. Is your practice ready to make the transition?

HIPAA 5010 is the new billing information standard that will replace 4010. It is necessary because 4010 does not support ICD-10, which will be required in 2013. The Department of Health and Human Services (HHS) requires health plans, health clearinghouses, and healthcare providers to switch over to 5010 on January 1, 2012.

5010 requires different data elements than 4010, so the transition will not be automatic. For instance, 5010 requires a physical address for the place of service. For more specific requirements, please see the official CMS educational resources page.

Practices should check with their billing service or software vendor to make sure they are ready for the transition. If your practice is not ready, it could result in CMS rejecting your claims and lead to a loss of revenue. Next, work with insurance companies to test 5010 claims submission. If there are issues, you do not want to find out after January 1st.

If you find out your billing software is not 5010 ready, you will need to upgrade or acquire new software as soon as possible. We can recommend a variety of billing software solutions to fit your practice. Please let us know if you would like any additional information about the 5010 conversion.

Ryan Ricks
Security Officer