CMS is pleased to report that the vast majority of provider claims are being sent to Medicare in 5010 format. Given these favorable results, we are taking the next step towards full implementation of 5010 in Medicare Fee-For-Service (FFS).
Effective Sun Apr 1, 2012, your Medicare FFS transactions must be in 5010 format. Transactions placed in 4010 formatting will be returned as unprocessable. Failure to submit 5010 formatting will result in your claim being unpaid/denied. Medicare FFS transition statistics are available for download at http://www.CMS.gov/EDIPerformanceStatistics/10_5010Statistics.asp. These statistics represent the transition from the current Health Insurance Portability and Accountability Act (HIPAA)-adopted Accredited Standards Committee (ASC) X12 Version 4010A1 and the National Council for Prescription Drug Programs (NCPDP) Version 5.1 transactions to the updated HIPAA ASC X12 version 5010 and NCPDP version D.0 transactions. The transition statistics cover the following: * Part A Claims and Remittances * Part B/DME Claims and Remittances * NCPDP Claims * Eligibility Inquiries and Responses * Claim Status Inquiries and Responses For more information on 5010, please visit http://www.CMS.gov/Versions5010andD0. ________________________________ It's Not too Late to Give and Get the Flu Vaccine. Take advantage of each office visit and protect your patients against the seasonal flu. Medicare will continue to pay for the seasonal flu vaccine and its administration for all Medicare beneficiaries through the entire flu season. The Centers for Disease Control and Prevention (CDC) also recommends that patients, healthcare workers and caregivers be vaccinated against the seasonal flu. Protect your patients. Protect your family. Protect yourself. Get the Flu Vaccine-Not the Flu. Remember - The flu vaccine plus its administration are covered Part B benefits. CMS has posted the 2011-2012 seasonal flu vaccine payment limits at http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp. Note that the flu vaccine is NOT a Part D-covered drug. For more information on coverage and billing of the flu vaccine and its administration, as well as related educational provider resources, visit http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp and http://www.cms.gov/immunizations. ________________________________ Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/ContactCMS). Thank you.
