Obscured by all of the buzz and excitement surrounding meaningful use and the EHR incentive program are two other areas within Health IT that require our attention. Most of us have heard of ICD-10 (some are even planning their retirement around the October 2013 deadline). However, few are familiar with ICD-10’s misunderstood cousin, the 5010 transaction standard.
As a bit of background, the Health Insurance Portability and Accountability Act of 1996 (that’s right, HIPAA receives most of the credit for our new friend the 5010 transaction standard) requires the Secretary of HHS to adopt standards that covered entities (like nephrologists) must use when electronically conducting certain health care related transactions (claims, remittance, eligibility, etc.—essentially the things one must do to receive compensation for services rendered).
Currently these electronic transactions occur using a different standard (the 4010/4010A1 standard, for those keeping score). Unfortunately the existing standard does not support the full breadth of data required by the health care industry, including paving the way for ICD-10. The solution? The more robust 5010 standard.
How will this impact the practicing nephrologist? Probably not at all. These transactions predominantly take place beneath the covers, in the realm of claims submission and remittance. But therein lies the rub. Out of sight should not mean out of mind. There is a firm deadline in place surrounding the adoption of this new standard which includes a very hard stop on January 1, 2012. After this date transactions conducted using the old standard will not be recognized.
What should you do? Somewhere north of 96% of all Medicare part B claims transactions are electronic so there is a very good chance the typical nephrologist will be involved. Make certain someone in your practice touches base with your billing service or practice management system. Most of these companies have been hard at work preparing for this change. Many will have communicated their plans and progress to you. If that has not occurred, give them a call and ask. Better to know where you stand today than to receive a painful surprise next January.