CMS Publishes ICD-10 Toolkit for Healthcare Providers; Includes Infographic, Fact Sheet

On October 1, 2015, ICD-10 became effective for all HIPAA-covered entities, and healthcare claims must now include ICD-10 codes for medical diagnoses and inpatient hospital procedures as indicated under the December 7, 2011 ICD-10 Final Rule [CMS-9998-FC] and amended by the August 4, 2014 Final Rule [CMS-0043-F].

To support ICD-10 implementation assessment, the Centers for Medicare & Medicaid Services (CMS) has released an ICD-10 Next Steps Toolkit to help healthcare providers track and respond to certain ICD-10 performance indicators to improve productivity and cash flow.

Specifically, the new Toolkit offers providers tips and resources for:

CMS Begins Enforcing New HIPAA Transaction Standards July 1, 2012, Version 5010 Resources Available

The Centers for Medicare & Medicaid Services (CMS) is reminding health care providers and others covered by the Health Insurance Portability and Accountability Act (HIPAA) that they must comply with the new Version 5010 and D.0 transaction standards for electronic health care claims by July 1, 2012.

The standards took effect January 1, 2012, but CMS twice delayed enforcement due to low compliance among some trading partners and reports that many covered entities were still awaiting software upgrades. As of July 1, 2012, non-compliance complaints received in CMS’ HIPAA Administrative Simplification Enforcement Tool will be subject to enforcement action under the existing HIPAA transaction and code set enforcement process.

Entities still experiencing issues regarding use of the Version 5010, D.0 and 3.0 standards in their transactions should refer to their respective vendor, clearinghouse, payer’s website or provider service department for assistance, CMS said. For more information, visit www.cms.gov.

WEDI-CMS-Industry Collaboration & Problem Solving Webinar

To address the Workgroup for Electronic Data Interchange (WEDI), CMS, and private industry concerns about remaining ASC X12 implementation-related issues, stakeholders came together to help the entire health care industry become fully complaint in ASC X12 5010 implementation. A multi-tiered campaign was launched to gather feedback, track challenges, and identify and provide guidance to correcting ASC X12 5010 implementation-related issues, especially among commercial payers.

On April 19, 2012, WEDI partnered with CMS on a webinar about industry collaboration and problem solving. View the WEDI-CMS PowerPoint and audio recording from the webinar to learn more.

Version 5010 Resources

CMS has developed the following fact sheets to help prepare you for the transition to Version 5010:

• FAQs: Versions 5010 and D.0 Transition Basics
• Versions 5010, D.0, and 3.0 Overview
• Version 5010: Testing Readiness, What You Need to Know
• Talking to Your Vendors About ICD-10 and Version 5010

Responses to Technical Comments about Version 5010

The Responses to Technical Comments on Version 5010 document is a compilation of the technical comments received during the public comment period of the proposed rule to adopt modifications to the HIPAA standards; specifically, Version 5010 of the X12 standard. The document includes the analysis and responses from subject matter experts affiliated with the Standards Development Organization (X12).

Further information and resources related to Version 5010 implementation, including an option to sign up for email update messages, is available on the ICD-10 – Version 5010 page on the CMS website.