Some Practices Still Lack Plan for 5010 Compliance Testing

With so much focus on adopting meaningful use EHR technology, many healthcare providers aren’t even glancing at other tech-related mandates less than a year away.

In fact, as many as one out of three health care providers don’t have a plan for 5010 compliance testing or implementation, according to the results of the third semi-annual HIMSS ICD-10/5010 Readiness Survey. The survey was based on 256 responses, 18 percent of which were from practices and clinics. The transition to for electronic claims transactions, which has a deadline of Jan. 1, 2012, is federally mandated to accommodate regulatory changes in billing processes such as EHR claims submission.

Survey respondents called out a number of obstacles to testing for compliance: payers not ready (67 percent); competition for resources (53 percent); vendors not ready (50 percent); and clearinghouses not ready (47 percent). Other projects are indeed taking priority (66 percent cited implementation of meaningful use of EHRs as the most important initiative to address).

Still, the deadline for 5010 compliance looms. And the deadline for the conversion from ICD-9 to ICD-10, though more than two years away (October 1, 2013), will require even greater preparation because it will impact medical practices’ clinical and business operations.

“Although there is understandably quite a bit of competition for health care providers’ resources and attention, addressing 5010 compliance must be a priority,” said Joe Miller, one of the primary survey authors and former chair of the HIMSS Medical Banking and Financial Systems Committee, in a statement.

If your practice is among those that hasn’t started 5010 and ICD-10 prep work, our readiness checklist is armed with questions you should ask your practice-management vendors, clearinghouses, and payers. Some questions you might not have thought of yet, such as asking your vendor, “Is the upgrade to 5010 included in our ongoing maintenance expense?” and “Will we be permitted to migrate to the 5010 standard prior to January 1, 2012?”

In a separate guide, Aetna outlines the nature of the changes of 5010 transactions, as well as ICD-10 codes, in its own guide.

How are you preparing for the transition to 5010 and ICD-10? Post your answer below.