EDI 5010

EDI 5010 Version Changes

EDI 5010 recent updates can influence correspondence in healthcare claims exchange and flow between partners. It is recommended that both parties take part in EDI 5010 updates testing procedures in order to prevent delays or issues in processing your claims cycle.

EDI 4010 to EDI 5010 basis

The centers for Medicare and Medicaid (CMS) require conversion from HIPAA Accredited Standards Committee (ASC) X12 version 4010A1 to ASC X12 version 5010. The Secretary of the Department of Health and Human Services (HHS) has adopted ASC X12 version EDI 5010 as the new HIPAA standard for HIPAA-covered transaction to be effective no later than January 1, 2012.

Unlike the current version 4010/4010A1, Version EDI 5010 accommodates the ICD-10 codes and must first be in place before the changeover to ICD-10 on October 1, 2013. Version 5010 has the ability to tell your practice management or other system that you are using an ICD-10 versus an ICD-9 code.

In order to be compliant with CMS standards, most clearinghouses involved in healthcare claims cycle required to test the Errata Version of 5010 X12 with submitters and payers. These updates highly encourage your organization to submit test files to your partners, as failure to test may affect your claims processing.

EDI 5010 transaction types being affected

Correspondence in EDI 5010 version updates can improve the quality and effectiveness of health care, enhance access to health benefits, create service that make health care more affordable and make the health care system easier to navigate.

EDI Academy offers up-to-date information regarding existing EDI standards in healthcare. Visit our seminars in your region.

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