CMS to Delay Enforcing 5010 Compliance


Center of Medicare and Medicaid announced that it will delay enforcing HIPAA 5010 transaction setsĀ  requiring hospitals, physician practices, health plans and claims clearinghouses to switch to using the ASC X12 Version 5010 standards for the electronic transmission of healthcare claims and other administrative communications until March 31, 2012 instead on Jan 1,2012 as originally planned.

This decision is the outcome of industry feedback revealing that, with only about 45 days remaining before the Jan. 1, 2012 compliance date, testing between some covered entities and their trading partners has not yet reached a threshold whereby a majority of covered entities would be able to be in compliance by January 1.


HIPAA 5010 standards regulate the transmission of certain health care transactions among hospitals, physician practices, health plans and claims clearinghouses. Converting to the HIPAA 5010 standards is seen as key to the larger switch from the ICD-9 clinical coding system to the ICD-10 system.

CMS is encouraging all covered entities to continue working with their trading partners to become compliant with the new HIPAA standards and to determine their readiness to accept the new standards as of Jan. 1, 2012. the largest consortium of billers and coders is helping not only physicians but also billers and coders to cope up with these changes and their consultancy services assisting them to get ready for new HIPAA standards.

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