EHR, Coding Compliance Deadlines Loom

The Centers for Medicare & Medicaid this week reminded healthcare providers, health plans, clearinghouses, and vendors about looming compliance deadlines for new diagnosis and procedure codes, and updated standards for electronic healthcare transactions.

The first compliance milestone for the Accredited Standards Committee X12 Technical Reports Type 3, Version 005010 (Version 5010) electronic healthcare transaction standards begins on Jan. 1, 2011. By then, HIPAA-covered entities should be ready to test the functionality of practice management and related software featuring Version 5010 standards.

Use of the Version 5010 standards for HIPAA electronic healthcare transactions, including claims, remittance advice, eligibility inquiries, referral authorization, and other administrative transactions, becomes mandatory on Jan. 1, 2012. Version 5010 standards also provide the framework for ICD-10-CM and ICD-10-PCS revised medical data code sets that must be in place on Oct. 1, 2013.

"The Version 5010 standards and ICD-10 codes are necessary steps to facilitate the national transition to an electronic healthcare environment," says CMS Administrator Donald Berwick, MD. "Transitioning to the Version 5010 transaction standards in 2012 and to the ICD-10 codes in 2013 will help accelerate the widespread adoption of health information technology and move the nation toward a more efficient, quality-focused healthcare system."

The expanded ICD-10 code sets will support quality reporting, pay-for-performance, bio-surveillance, and other critical activities, and provide terminology for electronic health records. The ICD-10 code sets will also link to the standards and certification criteria for demonstrating meaningful use of certified EHR technology under the Medicare/Medicaid EHR incentive program.