Part B Insider (Multispecialty) Coding Alert

Physician Note:

CMS Releases Updated, Aggressive 5010 Timeline

Plus: Congress has yet to pass 2012 payment fix.

CMS offered an early holiday gift to medical practices with the Nov. 17 announcement that it would not initiate enforcement action regarding 5010 until March 31, 2012. But even at the time, the agency did tell practices that they need to be able to prove that they're making a "good faith effort" to transition to the new data set. Now CMS puts its money where its mouth is, telling practices that they are being watched carefully--and that some practices will not actually have until March to switch to 5010.

The news: In a Dec. 14 news release, CMS announced that it is monitoring progress toward 5010 compliance and has found that some practices are unnecessarily dragging their heels. To spur those practitioners along, CMS announced the following action plan:

  • In Dec. 2011, "submitters/receivers that have tested and been approved for 5010/D.0 will be notified that they have 30 days to cutover to the 5010/D.0 versions"
  • Submitters/receivers that have not yet tested will be notified in Dec. 2011 "that they must submit their transition plan and timeline to their MAC in 30 days"
  • MACs will notify the submitters/receivers; "submitters/receivers have the responsibility to notify the providers they service."

To read more about CMS's plan, visit www.cms.gov/Versions5010andD0.

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