It’s CMS’ ‘5010 Testing Week’: How Are Things Going?

August 25, 2011
Marisa Torrieri

Many providers still haven't upgraded to 5010. This week, CMS staff is ready to help.

That CMS needed to schedule '5010 Testing Week’ this week suggests healthcare providers have fallen behind in upgrading to the new standard mandated by the Health Insurance Portability and Accountability Act (HIPAA).

But the fact that 5010 Testing Week commenced rather quietly on Monday doesn’t mean healthcare providers and aren’t concerned about the looming Jan. 1, 2012.

Robert Tennant, a senior policy advisor for the Medical Group Management Association (MGMA), recently told Physicians Practice there are a few reasons why practices are delaying.

One reason practices may delay 5010 is the costs associated with upgrades. Another reason is historical: 5010’s predecessor, Version 4010, was part of the original 1996 HIPAA law. However, it took a few years before its use was mandatory for covered entities as the standards had to go through a protracted regulatory process (which included compliance date extensions and lengthy contingency periods).

“What that has done is allowed some in the industry to say ‘there’s no rush for 5010,” Tennant said.

Cynthia Hughes, C.P.C., an AAFP coding and compliance specialist, in a recent news story warned of the consequences of not upgrading to 5010. Those practices that either aren’t prepared for the change or that encounter unexpected problems after implementation of the 5010 standards “likely will see delays in payment for services provided to all of their patients on or after Jan.1, 2012," said Hughes.

"Practices whose systems or clearinghouses are able to complete testing and go to production early should avoid such problems," she added.

CMS has committed ‘5010 Testing Week’ to helping practices resolve problems. The agency’s administrative contractors will be on hand to offer some support and answer questions.

We want to hear from you. Has your practice begun 5010 testing? What obstacles have come up along the way? Post your response below.