In an ideal world, payers and providers would be on the same page when it comes to ANSI X12, version 5010 compliance and ICD-10 code readiness. But a recent survey conducted by the Healthcare Information and Management Systems Society (HIMSS) indicates that most providers will not be ready to test their electronic health information systems by Jan. 1, 2011. Only 38 percent report that they have an actual system and 35 percent report that they have no plans to implement one.
On Jan. 1, 2012, standards for electronic health care transactions change from ANSI version 4010/4010A1 to version 5010. These electronic health care transactions include functions like claims, eligibility inquiries, and remittance. Unlike the current version 4010/4010A1, version 5010 accommodates the ICD-10 codes, and must be in place before the changeover to ICD-10.
It’s unlikely that providers will be able to make up ground to meet the January deadline, according to the survey. Providers also report difficulties in finding knowledgeable staff and vendors who are ready for the transition.
|In June 2010, providers reported only limited progress on 5010 compliance|
|Do not expect to have a 5010 project started before the end of 2010||33%|
|Haven’t even started an impact assessment, the first step in preparing for 5010||40%|
|Have an approved budget||21%|
|Started contacting vendors||15%|
|Have yet to consider 5010 planning||35%|
|Plan to upgrade existing system||74%|
|Plan to replace existing system||9%|
|Source: HIMSS 5010/ICD-10 Industry Readiness Survey|