Medicare Fee-For-Service Version 5010/D.0 Update for the Week of June 11, 2012
In its continuing effort to help trading partners transition to the new versions of standards adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) for electronically exchanging health care transactions, Medicare Fee-For-Service (FFS) has the following updates for the week of June 11, 2012: * Deadlines for using the new versions of HIPAA standards * A webinar announcement Deadlines Inbound Transactions: After close of business, June 29, 2012, you must submit only the following versions when sending Medicare FFS inbound transactions: § Accredited Standards Committee (ASC) X12 Version 005010 (5010) o Health Care Claim: Professional (837P) o Health Care Claim: Institutional (837I) o Heath Care Claim Status Request (276) § National Council for Prescription Drug Program (NCPDP) Version D.0 Claim Any inbound Medicare FFS transaction received by Medicare Administrative Contractors (MACs) in either version 4010/A1 or NCPDP 5.1 formats after normal close of business on June 29 will be rejected back to the submitter. If a claim transaction is rejected, the specific message you will receive will depend on the specific MAC receiving your claim file(s). Please visit the CMS Important 4010 - 5.1 Rejection Information<http://www.cms.gov/Medicare/Billing/MFFS5010D0/Important-4010-51-Rejection-Information.html> website for a detailed list of rejection error messages. Outbound Transactions: In addition, beginning July 1, 2012, the Coordination of Benefits (outbound ASC X12 837) and Health Care Claim Status Response (ASC X12 277) transactions will be sent in version 5010 only. Medicare FFS will be allowing an additional 30 days to complete the transition to the ASC X12 Health Care Claim Payment/Advice (835), also called the Remittance Advice. Therefore, as of August 1, 2012, Medicare FFS will be generating only the 5010 version of the 835 Remittance Advice for all trading partners. Please ensure you have tested with your MAC to successfully receive and process a parallel version 5010 835 Remittance Advice transaction during this transition period. Webinar Announcement CMS is offering regional webinars on Version 5010/D.0 conversion on June 20, 2012. The CMS Eastern webinar is set for 10am ET; Central webinar, 12pm CT; and Mountain-Pacific webinar, 1pm PT. Please register<https://registration.intercall.com/menu.php?short_name=cms2> to attend a webinar. More Information For more information on ASCX12 Version 5010 and NCPDP Version D.0, please visit the Versions 5010 and D.0<http://www.cms.gov/Versions5010andD0> website. ________________________________ 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.
