During the industry migration to the HIPAA 5010 transactions set, multiple problems related to insurer edits and adjudication processes arose that were not identified prior to implementation. These were problems that originated when claims management and transactions processing systems were updated, but not found until later.

A session at the ICD-10 Symposium on March 3 before the start of HIMSS13 in New Orleans will walk through the lessons of 5010 and how to avoid related issues that, if not identified early, could occur during the transition to ICD-10. “There may be issues with payer-related edits that could cause delays in processing claims,” says session presenter Mary Rita Hyland, assistant vice president of regulatory affairs at The SSI Group Inc., a revenue cycle software vendor and claims clearinghouse.

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