Hipaa Version 4010
hipaa version 4010
NaviNet committed to ICD-10 and HIPAA 5010 compliance
As many of you already know, healthcare providers, hospitals and health plans need to comply with an updated version of the International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD-10) by October 1, 2013. As a prerequisite to the ICD-10 compliance, healthcare organizations also need to adopt updated electronic transaction standards, known as HIPAA 5010, by January 1, 2012.
By virtue of NaviNet’s two-sided network business model, in which we offer solutions to both payers and providers, we are in a unique position to have broad knowledge of technology standards in general and ICD 10 and 5010 standards specifically, particularly as those standards relate to healthcare business operations and processes between and within payer and provider organizations. All NaviNet solutions will be ICD-10 and 5010 compliant in time to enable our customers to meet these regulatory milestones.
What is even more important that we share is that for NaviNet users the cost for IDC-10 compliance will be substantially less than the average expected costs. According to estimates by the Medical Group Management Association, the average cost of upgrading to ICD-10 for a three-physician practice will be $84,000. However, for those practices using NaviNet technology, the cost will be dramatically less. The NaviNet software as a service (SaaS) model makes it easy for providers to subscribe to and use standards-compliant technologies. NaviNet users do not have to invest in new systems or expensive upgrades to keep compliant with e-transactions; the SaaS model means that NaviNet does that work for them. NaviNet’s health plan-specific solution, NaviNet Insurer Connect, will be fully standards-compliant. And this fall, NaviNet will offer fully compliant EMR and PM solutions on the NaviNet platform.
For health plans, NaviNet is committed to fully supporting Version 5010 standards for electronic healthcare transactions, to enable our customers’ NaviNet solutions to be compliant. NaviNet will also continue to support Version 4010.
A bit of background to IDC 10 and the pending changes
International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases. All HIPAA covered entities must make the change; a prerequisite to ICD-10 is the adoption of EDI Version 5010 by January 1, 2012. ICD-10 will affect coding for everyone covered by HIPAA, not just those who submit Medicare claims.
What is driving the upgrade to ICD-10 is the fact that the current system is nearly 30 years old and its approximately 16,000 procedure and diagnosis codes are inadequate. ICD-10 codes are designed to enable diagnosis classifications that better describe the type and severity of medical conditions, increase capacity for quality measures, improve interoperability of electronic health records (EHRs), and facilitate more equitable reimbursement. These upgrades are not just a systems change; they are designed to drive better, more efficient patient care.
For more detailed information on ICD-10 and Version 5010, visit the Centers for Medicare & Medicaid Services Web site at http://www.cms.gov/ICD10/.
Looking ahead
We are looking forward to partnering with health plans, vendors and healthcare providers to help bridge the important but complex transition to ICD-10 and HIPAA 5010 compliance. We welcome your comments, insights, best practices as well as questions on our blog, on LinkedIn, Twitter, and Facebook. And, as always, we remain committed to keeping you abreast of any new critical developments in our industry.
Sincerely,
Kimberly Labow
Chief Marketing Officer
