Payers who conduct healthcare business electronically need to be aware of two major changes concerning standard transactions and code sets. On January 16, 2009, the Department of Health and Human Services (HHS) announced two new compliance deadlines which are enlisted below:
a) The new version of HIPAA standards known as 5010 will become effective on January 1, 2012. All healthcare organizations who are HIPAA compliant need to switch over to the new version of HIPAA 5010. The version that is being currently used by HIPAA compliant organizations is 4010.
b) Medical Coding standards are set to undergo major changes. ICD-10 codes will replace ICD-9 diagnosis codes for use in outpatient and inpatient departments and thereafter will replace ICD-9 procedure codes for inpatient department with effect from October 1, 2013. CPT codes will continue to remain as the codes used by medical practitioners or physicians for reporting procedures in outpatient department.