Achieving 5010 compliance is the first step in transitioning to ICD-10-compliant health care claims systems. The deadline for physician practices to achieve 5010 compliance – and avoid a breakdown in claims payment and the threat of federal fines – is January 1, 2012.

Many practices are a long way from achieving 5010 compliance, and some don’t even have a plan for getting there.

The solution is to work with a Medical Billing and practice management service that will not only guide you toward 5010 (and ultimately ICD-10) compliance, but one that will also make your medical billing and practice management system compliant and take on the burden of overcoming obstacles– without charging additional fees.

The deadline for implementation of the 5010 format for electronic transactions, January 1, 2012, is quickly approaching. All trading partners must be compliant on that date. For providers, being compliant means that your electronic transactions will be successfully received by payers in 5010 format and that you are able to successfully receive 5010 transactions any payer sends to you. This does not necessarily mean you need an upgrade or patch before January 1, 2012. Please review the contents in this web section very carefully.

This industry-wide change is a huge undertaking involving all entities who exchange data electronically; not only trading partners – providers and billing services, clearinghouses and payers – but the vendors who offer tools to support them. That’s where GroupOne and eClinicalWorks can help.

On November 17th, the Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services (OESS) announced that it would not initiate enforcement action until March 31, 2012. Read more 

Practices that do not comply with 5010 risk rejection of claims submitted after Jan 1, resulting in potentially substantial cash flow disruptions.  These future problems can be avoided by transitioning to an upgraded EHR system like eClinicalWorks.  Many practices are under the assumption that their claims will be paid with the old format until March 31, 2012 – THIS IS NOT TRUE.     

"It is not a good idea to get too comfortable with the extension," according to industry experts.