ICD-10 and Version 5010 Compliance Timelines
According to CMS, everyone affected by the Version 5010 (Claim) and ICD-10 transitions - health care providers, payers, software vendors, and clearinghouses/third-party billers - needs to prepare to meet the following timetable to ensure compliance.
| Date |
Compliance Step |
IHS Status |
|
January 1, 2010
|
- Payers and providers should begin internal testing of Version 5010 standards for electronic claims
|
Competing priorities delayed 5010 development 1/1/2011
|
|
December 31, 2010
|
- Internal testing of Version 5010 must be complete to achieve Level I Version 5010 compliance
|
Internal testing began in 2011 and is ongoing
|
|
January 1, 2011
|
- Payers and providers should begin external testing of Version 5010 for electronic claims
- CMS begins accepting Version 5010 claims
- Version 4010 claims continue to be accepted
|
CMS-IHS Fiscal Intermediaries (FIs) begins accepting Version 5010 claims
|
|
December 31, 2011
|
- External testing of Version 5010 for electronic claims must be complete to achieve Level II Version 5010 compliance
|
External Testing began May 2011 and is ongoing.
|
|
January 1, 2012
|
- All electronic claims must use Version 5010
- Version 4010 claims are no longer accepted
|
IHS began February 2011 and will meet the January 1, 2012 deadline
|
|
October 1, 2013
|
- Claims for services provided on or after this date must use ICD-10 codes for medical diagnosis and inpatient procedures
- CPT codes will continue to be used for outpatient services
|
In November 2010, Steering Committee and Sub-groups established to address ICD-10 Implementation
|
IHS X12 Version 5010 Timelines
| X-12 Phased Release |
Release Date |
Associated Activities |
|
837P
|
May 2011
|
837P & 837I Associated Activities
- Perform a practice-wide 5010 impact assessment
- Obtain vendors' plans for software updates and/or testing schedules
- Identify key practice metrics to monitor pre- and post-implementation
- Finalize plans to update software, practices processes and internal policies
|
|
837I
|
October 2011
|
837P & 837I Associated Activities
- Perform a practice-wide 5010 impact assessment
- Obtain vendors' plans for software updates and/or testing schedules
- Identify key practice metrics to monitor pre- and post-implementation
- Finalize plans to update software, practices processes and internal policies
|
* The 837I & 837P does not include development for ICD-10.
| X-12 Phased Release |
Release Date |
Associated Activities FY2012 |
|
837D
|
October 2011
|
837D & 835 Associated Activities FY2012
- Obtain vendors' plans for software updates and/or testing schedules
- Identify key practice metrics to monitor pre- and post-implementation
- Finalize plans to update software, practices processes and internal policies
|
|
835
|
November 2011
|
837D & 835 Associated Activities FY2012
- Obtain vendors' plans for software updates and/or testing schedules
- Identify key practice metrics to monitor pre- and post-implementation
- Finalize plans to update software, practices processes and internal policies
|
* The 837D does not include development for ICD-10.
IHS NCPDP Version D.0 Timelines
| CMS Compliance Dates |
IHS Dates |
IHS Implementation Status |
|
January 1, 2010: Internal Testing
|
April 2010
|
5.1 - D.0 GAP Analysis
|
|
January 1, 2010: Internal Testing
|
October 2010
|
Planning
|
|
January 1, 2010: Internal Testing
|
December 2010
|
Developer Analysis
|
|
January 1, 2010: Internal Testing
|
February 2011
|
Development
|
|
December 31, 2010: Internal Testing
|
March 2011
|
Alpha Testing
|
|
January 1, 2011: Internal Testing
|
September 2011
|
D.0 Testing with Emdeon
|
|
December 31, 2011: External Testing
|
October 2011
|
Beta Testing
|
|