CMS Issues Reminder on January 2011 Target for Testing Transaction Using ICD-10 Code Sets

The Centers for Medicare and Medicaid Services issued a reminder this week to health care providers, health plans, clearinghouses and vendors about the approaching compliance dates for a new generation of diagnosis and procedure codes and updated standards for electronic health care transactions (ICD-10 code sets).

Beginning in January 2011, entities covered under the Health Insurance Portability and Accountability Act (HIPAA) should be ready to test with their trading partners the functionality of the entities’ practice management and/or other related software featuring Version 5010 standards (compliance with Accredited Standards Committee X12 Technical Reports Type 3, Version 005010). Use of the Version 5010 standards for HIPAA electronic care transactions, including claims, remittance advice, eligibility inquiries, referral authorization, and other administration transactions, will be mandatory on January 1, 2012. The Version 5010 standards also provide the framework needed for use of the revised medical data code sets (ICD-10-CM and ICD-10-PCS), that must be implemented on October 1, 2013.

To help health care providers, health plans, clearinghouses and vendors work toward the compliance dates for Version 5010 and ICD-10, to avoid delays in claims processing and payment, CMS has been conducting ongoing industry outreach and education, and most notably, has revised its ICD-10 website. Download all the free information at

Click here to read the CMS press release that was issued on August 24, 2010.


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