{"id":1252,"date":"2011-12-26T11:00:15","date_gmt":"2011-12-26T16:00:15","guid":{"rendered":"http:\/\/www.poweryourpractice.com\/?p=1252"},"modified":"2011-12-26T11:00:15","modified_gmt":"2011-12-26T16:00:15","slug":"10-tips-on-hipaa-5010-be-sure-youre-compliant","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/10-tips-on-hipaa-5010-be-sure-youre-compliant\/","title":{"rendered":"10 Tips on HIPAA 5010: Be Sure You\u2019re Compliant"},"content":{"rendered":"

As of January 1, all electronic administrative transactions in the U.S. healthcare system should comply with the updated standards of HIPAA Version 5010.<\/p>\n

Hopefully you upgraded your software, revised your templates and educated yourself on the 5010 changes in time for the conversion deadline<\/strong>.<\/p>\n

<\/p>\n

But even if you\u2019re pretty sure you covered all your bases before last year’s end, now is the time to double-check the details. The Centers for Medicare & Medicaid Services (CMS) won\u2019t track you down to enforce compliance until July<\/a>, but if there\u2019s a hole in your process where a violation is taking place now, you need to catch the issue in time to resolve it before CMS starts applying penalties.<\/p>\n

Follow these pointers from Power Your Practice<\/em> to keep violations from slipping through the cracks.<\/p>\n

1. Make Sure You\u2019re the Billing Provider
\n<\/strong>Under 5010 standards, the company or organization that provides the billable service is the one that should be listed as the billing provider \u2013 not the clearinghouse or billing company<\/a>.<\/p>\n

2. Check That Address
\n<\/strong>To be HIPAA 5010 compliant, all transactions must include the actual street addresses of the service facility and billing provider, plus their complete 9-digit zip codes. PO boxes are no longer acceptable.<\/p>\n

3. Be Consistent With Your NPI
\n<\/strong>If you\u2019re not reporting under the same National Provider Identifier to all of your payers, you\u2019re not 5010 compliant. Identify your official NPI and make sure you use it in every transaction.<\/p>\n

4. Mark the Minutes
\n<\/strong>All anesthesia services must be reported in minutes<\/a>, not units, under HIPAA 5010. If \u201cunits\u201d remain on your anesthesia forms, update them ASAP.<\/p>\n

5. Consult With Your Trading Partners
\n<\/strong>Don\u2019t assume everyone\u2019s ready to receive 5010 transactions. Find out if one of your payers or clearinghouses is using CMS\u2019 non-enforcement window as an excuse to wait until March to upgrade their systems.<\/p>\n

6. Remember the Diagnosis Code
\n<\/strong>It may have been rare that you sent a claim without one, but it\u2019s worth reminding your coders: Under HIPAA 5010, every single claim must contain a diagnosis code.<\/p>\n

7. Double-check: Subscriber\/Patient
\n<\/strong>The individual who has a unique member identifier from your payer<\/a> is the one you must list as the subscriber in your transactions. If the policyholder is the patient, list him only as a subscriber \u2013 leave \u201cpatient\u201d blank. If a dependent is your patient, list the policyholder as the subscriber and the dependent as the patient.<\/p>\n

8. Check for Your Tax ID
\n<\/strong>The billing provider\u2019s tax ID is required on all 5010 claims. Since the care provider is now always the billing provider, be sure you\u2019re putting your practice\u2019s tax ID on your transactions.<\/p>\n

9. Review How Many Codes Point to Your Service Line
\n<\/strong>HIPAA 5010 increases the number of diagnosis codes allowable on a claim from eight to twelve, but only a maximum of four of those codes can be linked to a service at the service line level. Should a service relate to more than four of your patient\u2019s diagnoses, point to no more than four of them when billing that service line.<\/p>\n

10. Get Validation of Your Compliance
\n<\/strong>If you have any doubts about the HIPAA 5010 compliance<\/a> of your transactions, get in touch with a validation service. They\u2019ll confirm whether you\u2019re following implementation guidelines and may be able to help you make last-minute changes to your forms or processes.<\/p>\n

Are you transacting in the HIPAA 5010 standard?<\/strong><\/p>\n

Madelyn Young is a Content Writer for CareCloud and an expert on practice management, medical billing, HIPAA 5010, ICD-10 and revenue cycle management. You can read her work on Power Your Practice and the\u00a0CareCloud Blog<\/a>. Contact Madelyn with story suggestions, contributor articles, or any other feedback at\u00a0madelyn@poweryourpractice.com<\/a>\u00a0or follow her on Twitter\u00a0@madelyn_young<\/a>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

As of January 1, all electronic administrative transactions in the U.S. healthcare system should comply with the updated standards of HIPAA Version 5010. Hopefully you upgraded your software, revised your templates and educated yourself on the 5010 changes in time for the conversion deadline.<\/p>\n","protected":false},"author":1,"featured_media":32785,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,8],"tags":[38,39],"class_list":["post-1252","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revenue","category-trends","tag-icd-10","tag-revenue"],"yoast_head":"\nTips on HIPAA 5010: Be Sure You\u2019re Compliant - Continuum<\/title>\n<meta name=\"description\" content=\"Tips on HIPAA 5010: Be Sure You\u2019re Compliant. 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