5010

5010 Defined
5010 is the new HIPAA electronic transaction standard. It is the only transaction version accepted by insurance companies as of January 1, 2012. This new transaction version standardizes the contents of medical transactions (e.g. claims, remits and eligibility) by specifically designating what content can be placed where in the transaction file.

New Year - New Standard - 5010 is still Coming
CMS's Office of E-Health Standards and Services issued a press release stating that it would not enforce compliance with the new 5010 transaction standards until March 31, 2012. However, the compliance date remains January 1, 2012.

Transaction Types Affected
Claims
Electronic Remittance Advice (ERA)
Eligibility
Premium Payments
Referral Authorization
Plan Enrollment
Claim Status Request / Response

Navicure is Prepared

• Navicure is sending 5010 claims to all major medical payers including Medicare, BCBS, Aetna and United. We are currently accepting 4010 and 5010 claims from most PM systems.
• We prepared months in advance for this transition and responded to problems that many clearinghouses are just now identifying.
• We take pride in our award-winning customer service - transitions are no exception.

ICD-10
On October 1, 2013 the government-mandated switch from ICD-9-CM codes to ICD-10-CM and ICD-10-PCS codes will take place. 5010 enables the use of the ICD-10 code sets. Therefore, since Navicure’s 5010 transition is complete), we are able to handle the ICD-10 code sets.

Additional Resources

Navicure receives full accreditation from the Electronic Healthcare Network Accreditation Commission (EHNAC).

ICD-10 Hub – website sponsored by Navicure and the American Academy of Professional Coders (AAPC) with resources to make the transition to 5010 and ICD-10 easier for physician practices

FAQ – 5010 frequently asked questions document

White paper – How 5010 Will Enhance Practice Profitability: A Preparation Guide for Physician Practices

Webinar – 5010 – Opportunity or Chaos? Strategies to Survive the Transition

CMS (in particular, see HIPAA section)

CMS MLN Matters – An Introductory Overview of the HIPAA 5010

Federal Register – HIPAA Update

ANSI X12 Website

We will be updating this section of the website as new information becomes available. Please continue to check back for updates. For more information, you can also contact transition@navicure.com.