Iridium Suite 5010 Compliance

 

  • 5010 is the new health care electronic transactions standard that will be put into effect on January 1, 2012.  The new standards cause sweeping changes to the manner in which electronic billing transactions are coded.
     
  •  Iridium Suite will be fully compliant with the new 5010 standards prior to the January 1, 2012 deadline.
     
  •  As a result, each of our customers will also be fully compliant with 5010.
     
  • 5010 compliance will be provided to Iridium Suite’s customers at no additional charge.  
     
  • The necessary system changes for 5010 will be completed by our IT staff and will require no work on the part of our customers or their staff.
     
  • Iridium Suite was developed at the same time that electronic billing was coming to the forefront, so our software was designed around electronic billing standards from its inception.  Iridium Suite’s work flow is organized around the processing of electronic claims and remittances at the service line level rather than at the claim level.  This fact will enable Iridium Suite and its users to experience a smoother transition to the new 5010 standards than the users of other systems.
      
  • In addition, while some medical billing software programs will find it difficult, or impossible, to accommodate the longer   ICD-10 codes (7 bytes as compared to 5 bytes with ICD-9), Iridium Suite was developed with expanded diagnosis code length in mind.  This is another advantage of Iridium Suite’s software.
What is 5010?

5010 is the new health care electronic transactions standard.  5010 is an abbreviated way to reference Version 005010 of the Accredited Standards Committee (ASC) X12 Technical Reports Type 3 (TR3s).  5010 will replace the current health care transaction standards, Versions 4010/4010A1.

The current 4010 standards are limited in their ability to transmit certain data elements that are required by HIPAA (the Health Insurance Portability and Accountability Act).  The new 5010 standards will enable clearer instructions, reduced ambiguity in the data that is used in electronic transactions and the elimination of redundant and unnecessary data elements.

The compliance date for 5010 is January 1, 2012.  All electronic transactions must be in the new 5010 format as of that date.  Transactions that are sent electronically using the old 4010 standards on or after January 1, 2012 will be rejected, causing medical claim payment delays.

The following entities must comply with 5010 no later than the January 1, 2012 deadline date:

  • Providers, such as physicians, alternate site providers, rehabilitation clinics and hospitals
  • Health plans
  • Health care clearing houses
  • Medical billing services, agents and vendors

 

The new 5010 standards must be in effect in order for the International Classification of Diseases, 10th Revision to be implemented.  The current ICD-9 codes are 5 bytes in length whereas the new ICD-10 codes are 7 bytes in length.  The new 5010 format accommodates the increased length of diagnosis codes.