WHAT IS 5010?
Since the HIPAA Law was enacted, Healthcare Electronic Data Interchange (EDI) transactions have been operating in the 4010 format. When people talk about the “5010 transition”, they are referring to a change in electronic version. The designation “4010” is a version number attached to a certain way of arranging electronic data. Since 2002, the industry has been working on a redesign to address some of the identified needs and known problems. HIPAA II has adopted the “5010” version, and it is mandated for nation-wide implementation by January 1, 2012.
One exciting change is the ability of 5010 transactions to support the upcoming changes planned for the diagnosis and procedure coding system (see “What is ICD-10?”). The 4010 version is not able to accommodate the new, longer codes. The 5010 version takes the needs of ICD-10 into account.
There are substantial changes from a software perspective between 4010 and 5010. Some changes are structural, others are cosmetic. Many of these changes will be invisible to providers, because they will occur in the coding behind the scenes. There are, however, some changes that providers will see. Two report types will get slightly different names, and some others will get additional content. There will also be some changes in the way the data is laid out, although most of the data will remain the same.
Although many changes will be invisible to providers, there are still some steps you will need to take to be prepared. Not becoming “5010 ready” will likely lead to failed transactions after January 1, 2012. Check out the rest of the 5010 Resource Center for information about the 5010 timeline, testing requirements, what to expect, and more.
