Posts Tagged NCPDP

Time is Running Out for 5010 Compliance

The Medicare 90-day discretionary enforcement period for non-compliant Health Insurance Portability and Accountability Act (HIPAA)-covered entities to begin using the new versions of the X12 standards for electronic transactions ends June 30. Beginning July 1, only the new ASC X12 Version 5010 and National Council for Prescription Drug Program (NCPDP) Telecom D.0 formats will be accepted by Medicare contractors. (more…)

June 18th, 2012

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5010 required by January 1, 2012

CMS held a conference call presentation on 5010 Implementation with Chris Stahlecker and Lorraine Doo, CMS, Office of Information Services, as the speakers. During their presentations they made the following main points.

Need for 5010 Conversion

  • More than 5 years since initial implementation, but 8 years since balloting of the current version
  • Many situational and required rules did not fit business practices of the industry
  • Industry relied too extensively on companion guides, limiting value of standards
  • Many transactions were not implemented at all because of limited utility and value.

Why 5010 is an Improvement over 4010

  • Includes structural and content oriented changes
  • Incorporates more than 500 change requests
  • Resolves ambiguities in situational rules
  • Provides more consistency across transactions – most rules are the same throughout the suite
  • Shortcomings have been addressed to increase value of transactions such as referrals and authorizations. (more…)

June 10th, 2009