CMS Updates for 5010 and ICD-10 Implementation

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CMS Updates for 5010 and ICD-10 Implementation

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Centers for Medicare & Medicaid Services (CMS) recently announced extensions to implementation for the 5010 and ICD-10 initiatives.  These extensions will allow providers a little extra time in preparing their billing operation for compliance. There have been a few extensions for the 5010 standards as it was originally expected to be implemented at the beginning of 2012.  This deadline was then extended to April 1.   The penalty-free phase has now been extended once more through July 1 to accommodate providers and payers that had not successfully tested and implemented the claim guidelines. CMS and payers caution providers not to put off compliance with 5010 standards, on the contrary they highly recommend the sooner compliance can be attained, the better.  June 30 most likely will be the last day before penalties for not correctly using 5010 are imposed. The same is advised for ICD-10 implementation. Last week, CMS proposed a one-year extension of implementation to Oct. 1 in the Federal Register.  Experts advise billers and billing departments to take advantage of the extra year to learn how ICD-10 will impact their operations, create a transition plan, and begin taking steps to make changes to systems and processes now.  Providers will need to work with payers, electronic health record and practice management system vendors, providers, and coders to coordinate activities and develop new processes to ensure revenue flow is uninterrupted. The 30-day comment period for this rule is open now, and is an important way to offer your opinion about the proposed ICD-10 compliance date change. You can submit comments in the following ways:

  • Electronically, by following the ''Submit a comment'' instructions on the Regulations.gov website
  • Send a letter to: Centers for Medicare & Medicaid Services Department of Health & Human Services Attention: CMS–0040–P P.O. Box 8013 Baltimore, MD 21244–8013
More information about the proposed rule can be found in the One-Year Delay of ICD-10 Compliance Date fact sheet, which outlines the background of the ICD-10 compliance date, and highlights provisions of the proposed rule and 5010 standards compliance date.