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San Francisco Marin Medical Society Blog

Medicare Announces Another Extension of HIPAA 5010 Enforcement



The Centers for Medicare & Medicaid Services (CMS) announced yesterday that they would again extend the enforcement discretionary period, allowing practices an additional 90 days to become fully compliant with the use of HIPAA 5010 transaction standards.

What this means for physicians is that while the implementation date of January 1, 2012, is still in effect, contractors will not reject claims submitted in the 4010 electronic formats until July 1, 2012.

CMA has also surveyed the major payors in California to understand whether they will require claims to be submitted in 5010 format on April 1. While some did require 5010 on January 1, others were allowing for contingencies until April 1. SFMS members will receive a quick reference guide with information on which major payors will require 5010 transactions on April 1 in the March SFMS eNewsletter (due out today).

SFMS/CMA encourages all physicians to continue working with their vendors, clearing houses and billing services to transition to the 5010 format as soon as possible. Offices that transmit directly must ensure their software is updated.



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