ICD-10 & HIPAA 5010

Latest Information

MVP Health Care would like to assist providers and their staff in the training and education process in preparing for ICD-10. Please email Mary Ellen Reardon for ICD-10 coding questions and/or to obtain specialty specific training materials for your office or call(585) 279-8583.

The eMedNY Provider Testing Environment (PTE) is available for ICD-10 end-to-end testing.The PTE replicates the eMedNY production system and end-to-end testing offers eMedNY submitters a great opportunity to identify any deficiencies and take necessary corrective action in advance of the October 1, 2015 compliance date. Details about the PTE can be found here.

"Protecting Access to Medicare Act of 2014 Passes -  ICD-10 Implementation Delayed" from Kern Augustine Conroy & Schoppmann, P.C.

March 31, 2014 - The Senate passed HR 4302, which includes the ICD-10 one-year delay. President Obama is expected to sign the legislation into law. Click here for an AMA section-by-section summary of HR 4302.

"Protecting Access to Medicare Act of 2014 Passes -  ICD-10 Implementation Delayed" from Kern Augustine Conroy & Schoppmann, P.C.

ICD-10 FAQ from Monroe County Medical Society.

Is Your Practice Prepared for ICD–10?  from Monroe County Medical Society.

CMS has developed an online ICD-10 implementation guide. This web-based tool includes a basic overview of ICD-10 as well as step-by-step guidance on how to transition to ICD-10 for small/medium practices, large practices, small hospitals, and payers.

CMS eHealth University, a resource to help providers understand, implement, and successfully participate in ICD-10 and other CMS eHealth programs, features a full curriculum of materials and information, all in one location. The education modules are organized by level, from beginner to advanced, and simplify complex information in a variety of formats, including fact sheets, guides, videos, checklists, webinar recordings, and more.

Earlier Information

I-STOP requires physicians and other prescribers to consult the NYS database before prescribing Schedule II, III and IV medications. The duty can be delegated to staff, including unlicensed staff. There are several exemptions to the Duty to Consult. See attached for more information. Please note, the inpatient exemption does not apply when the prescription is being written at discharge. Click here for a brochure on How to Establish a Health Commerce System Account and Using the Health Commerce System.

CMS delays 5010 enforcement: The CMS has announced it will not begin enforcing the mandated move to Version 5010 transaction standards until after June 30. The deadline for the switch to the 5010 standards was Jan. 1. In November, the CMS announced that although it was not changing the actual deadline for complying with the standards, it would not initiate enforcement action until March 31.

P.O. Boxes No Longer Permitted in Billing Provider Address in 5010
With 5010, the Billing Provider Address used on claims must be a physical address.  Once 5010 is implemented, you can no longer use PO Box and lock box addresses as a billing provider address. If you submit claims electronically, you will be required use only a street address or physical location as the billing provider address.  Continuing to report a P.O. Box in the billing provider address field will cause your claims to reject. More

New ICD-10 Implementation Handbooks Now Available
CMS has developed four Implementation Handbooks as additional resources to assist the health care industry with the transition from ICD-9 to ICD-10 codes. Each guide provides detailed information for planning and executing the ICD-10 transition process.

Version 5010 Resources
CMS has developed the following fact sheets to help prepare you for the transition to Version 5010:

FAQs: Versions 5010 and D.0 Transition Basics 
Versions 5010, D.0, and 3.0 Overview 
Version 5010: Testing Readiness, What You Need to Know 
Talking to Your Vendors About ICD-10 and Version 5010

Preparing for ICD-10
In 2013, CMS will require the use of ICD-10 for coding of diagnoses in billing/administrative transactions. The following resources may be useful:
>This timeline tool may be helpful in developing a plan for ICD 10 conversion.
>The AMA published a series of fact sheets about ICD-10.
>Additional Online Resources

White Paper Resource:

Are You Ready for the New ICD-10 and Electronic Version 5010?
Changes Start Taking Effect in January of 2012...

By: Robert J. Conroy, Esq., Denise Sanders, Esq., Matthew R. Streger, Esq., and Peter D. Espey, Esq.
The International Classification of Diseases (10th edition) (ICD-10) codes will take effect on October 1, 2013. While this may seem far off, according to the Centers for Medicare and Medicaid Services (CMS), physicians should begin preparing for the changes immediately. Read more