Home Health & Hospice Week

ICD-10 implementation may not come until 2013, but a big change making way for the coding set transition will arrive as early as January. In preparation for the use of the new ICD-10 diagnosis coding set, the Centers for Medicare & Medicaid Services has introduced its new HIPAA 5010 form, said Christine Stahlecker of CMS's Office of Information Services, during a June 15 Open Door Forum entitled "ICD-10 Implementation in a 5010 Environment." The form will be required for all Health Insurance Portability And Accountability Act-covered entities (i.e., providers, health plans, clearinghouses, and their business associates, including billing agents) as of Jan. 1, 2012, Stahlecker said.

Although CMS has noted the fact that the new 5010 form is a prerequisite for ICD-10 implementation (due to its increased field sizes and increased number of diagnosis codes allowed on a claim), the agency also stressed the fact that the new 5010 does not do the ICD-10 prep work for you. "With our 5010 project, we are not adding any processing of the ICD-10 code values, and we are not including any crosswalk from ICD-9 to ICD-10," Stahlecker said. "So although the 5010 form permits both the ICD-9 and ICD-10 code values, only ICD-9 will continue to be processed up until the ICD-10 project permits ICD-10 codes to come in."

Timeline: Keep in mind that CMS will begin accepting 5010 forms effective Jan. 1, 2011, and use of the form will be required as of Jan. 1, 2012. The ICD-10 codes will take effect on Oct. 1, 2013.

If you're not ready to submit the 5010 form by Jan. 1, 2012, "you will no longer be able to submit electronic transactions" to Medicare, Stahlecker said. Paper claim submitters will keep the status quo, however. "Providers that are submitting paper claim forms today should not experience a change in that paper claim form for 5010 or the ICD-10 projects," Stahlecker said in the call. "Our understanding is at this time, those paper claim forms can already accommodate the additional length of the diagnosis codes."