CMS pushes for uptake of transaction standards
By Brian Robinson
Monday, November 23, 2009
The Center for Medicare & Medicaid Services is pushing to ensure it meets fast-approaching deadlines for putting new electronic transaction and billing standards in place, its e-health leader said last week.
The agency’s systems staff is on schedule to start testing for compliance of the new 5010 version of the X12 standards for HIPAA transactions in January 2011, according to Tony Trenkle, director of the Office of e-Health Standards and Services at CMS.
Trenkle spoke at a meeting last week of the National Committee on Vital and Health Statistics (NCVHS).
At the same time, CMS recently completed an impact statement required for launching Version 10 of the International Classification of Diseases (ICD-10) billing and diagnostic codes, and is looking ahead to beginning talks with business owners on how ICD-10 will affect their business processes.
ICD-10, which includes more than 155,000 codes for classifying health care diagnoses and procedures, will be a replacement for the current 17,000 ICD-9 code set. Version 5010 of the HIPAA standards includes improvements in structural and data content such as improved eligibility responses and better search options. It is considered a necessary precursor for the implementation of the new ICD-10 diagnosis codes.
Current schedules call for most organizations covered under Medicare and Medicaid to be fully compliant for version 5010 by Jan. 1, 2012. The deadline for all entities to begin using ICD-10 is Oct. 1, 2013.
Trenkle said ICD-10 presents risks for the health care industry, but also opportunities.
“For example, ICD-10 is not just an implementation, it’s a way to change how you do business,” the NCVHS meeting attendees. But “the time to begin looking at that is before you implement, not after.”
The key to that is the health industry’s understanding of what both 5010 and ICD-10 means for it, and it’s not clear what the level of that understanding is. So Trenkle said the CMS has begun engaging with a number of business leaders to drive implementation, and has hired a contractor to provide national outreach on both 5010 and ICD-10.
Upcoming meetings of the NVCHS and other groups will provide could provide a good marker for where the industry’s understanding is at, and what challenges remain, he said.
