5010 Basics
Who is required to make changes for 5010?
All covered entities are included in the 5010 industry-wide mandate. The definition for a covered entity is a health plan, a health care clearinghouse or a health care provider who transmits any health information in electronic form in connection with a HIPAA transaction.
Why is the electronic format for health care transactions changing again?
The current format, already eight years old, is unable to meet some important new developments in health care such as supporting the ICD-10 code set and pay for performance. Other changes in the 5010 version will streamline reimbursements. Most of the changes are technical and geared toward improved standardization and uniformity. Many of these can be handled by your vendor and clearinghouse. However, it is important that you understand your own responsibilities in order to become 5010 compliant.
Does 5010 include changes for the CMS-1500 form for professional claims?
The 5010 standards control electronic transactions. The CMS-1500 form is maintained by the National Uniform Claim Committee (NUCC). NUCC has discussed minor changes to the existing CMS-1500, but no changes have been announced as of yet. The current form is Version 6.0, which was released July 1, 2010, with usage clarifications and appendices. No format or data requirements were implemented for 5010. For more details, you can visit the NUCC website at
Medicare Guideline posts
- Home
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation process - how often provide need to do - FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
Subscribe to:
Post Comments (Atom)
Top Medicare billing tips
-
Procedure code 77427: Radiation treatment management, 5 treatments Procedure code 98966: Telephone assessment and management service provi...
-
CPT 99201 Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: a...
-
CPT 99211 Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of...
-
Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee... -
CPT CODES and Description 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitr... -
This post has Most used J code list and we are constantly updating with example . If you are looking particular J code, use search button. ...
-
Procedure code and description 93224 - External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage;...
-
Procedure Codes and Definitions 36415 Collection of venous blood by venipuncture - Fee schedule amount $3.10 - Private insurance pay upt... -
Procedure code and description 11400- Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion d...
-
CPT CODE and Description 90785 - Interactive complexity (List separately in addition to the code for primary procedure) 90791 - Psychi...
No comments:
Post a Comment