The January 2012 compliance date for version 5010 of the HIPAA transaction sets is right around the corner, with testing for Medicare claims starting in January 2011. Further, 5010 compliance is a precursor to implementation of the ICD-10 diagnosis and procedure code sets, with an October 2013 compliance date.

An educational session at the Medical Group Management Association's Annual Conference, Oct. 24-27 in New Orleans, will offer medical practices critical information they need to know to better prepare for both compliance initiatives. "Our task is not only to explain, but give a roadmap to help practices get ready for this transition," says Robert Tennant senior policy advisor for government affairs at MGMA.

Tennant will present the session with Larrie Dawkins, chief compliance officer at Wake Forest University's Health Sciences Center in Winston-Salem, N.C. They will discuss challenges that will arise with both 5010 and ICD-10, critical software modifications, upcoming compliance dates and a toolkit that MGMA and the American Medical Association developed to aid practices.

Tennant doesn't mince words at the work ahead, particularly to achieve ICD-10 compliance. "IDC-10 promises to be one of the most complex changes ever faced by medical groups."

But 5010 won't be a slam-dunk either. Software vendors, for instance, lagged behind other stakeholders in their readiness for the HIPAA 4010 transactions set, as well as the national provider identifier, Tennant notes. Now, 5010 is a launching pad for ICD-10, so physician practices need a game plan for how they will deal with their vendors. "We know vendors are very focused on meaningful use. Hopefully, 5010 is on their radar screens."

The time is now to find out when vendors will be providing 5010 upgrades and to get on their testing schedules, Tennant advises. "We're pushing the Centers for Medicare and Medicaid Services to implement a national testing day in June 2011," he adds. "If your vendor can't commit to being ready in June, it's time to look hard at your vendor options."

Practices assuming the feds will delay 5010 and ICD-10 deadlines likely will be in for a rude surprise, Tennant cautions. "CMS has been pretty definitive that it won't push back the compliance dates."

The educational session, "D4, IDC-10 and the New HIPAA 5010 Transaction Standards," is scheduled for 10:15 a.m. on Tuesday, Oct. 26. More information is available at

--Joseph Goedert


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