Version 5010 Industry Resources

Version 5010 refers to the revised set of HIPAA electronic transaction standards adopted to replace the current Version 4010/4010A standards. Every standard has been updated, from claims to eligibility to referral authorizations.

As of January 1, 2012 all HIPAA covered entities must be compliant with Version 5010.  Any electronic transaction for which a standard has been adopted must be submitted using Version 5010.  Electronic transactions that do not use Version 5010 are not compliant with HIPAA and will be rejected. 

HHS authorized an enforcement discretion period through June 30, 2012.  During this time, CMS did not initiate enforcement action against any covered entity that was not compliant with the updated Version 5010/D.0 standards. 

Industry Collaboration 

WEDI, CMS, many industry organizations, and stakeholders collaborated on a series of three webinars to help the entire health care industry become fully complaint in ASC X12 5010 implementation. A multi-tiered campaign was launched to gather feedback, track challenges, and identify and provide guidance to correcting ASC X12 5010 implementation-related issues, especially among commercial payers.

The last webinar was held on June 25, 2012.  View the WEDI_CMS Power Point and audio recording from the webinar to learn more.  

The online issues reporting tool is available to help address ongoing issues.  Covered entities may continue to submit issues associated with implementing ASC X12 5010, and search through a database documented problems.  

Version 5010 Resources
CMS has developed the following fact sheets to help you prepare for the transition to Version 5010:

• FAQs: Versions 5010 and D.0 Transition Basics
• Versions 5010, D.0, and 3.0 Overview
• Version 5010: Testing Readiness, What You Need to Know
• Talking to Your Vendors About ICD-10 and Version 5010

Version 5010 Email Updates
Sign up to receive the email update messages and check out the recent Version 5010 messages:

• How to Avoid Common Version 5010 Claims Rejections
• Denise Buenning from CMS Answers the Industry's Top Questions about the Version 5010 Upgrade
• Slides and Comments from the WEDI-CMS Industry Collaboration and Problem Solving Webinar are Now Posted
• Guidance on Troubleshooting Claims Submissions for Version 5010
• Have You Completed Your 5010 Implementation?
• Ensure a Smooth Version 5010 Upgrade: Use CMS’ Online Resources
• Refining Your Upgrade to Version 5010
• Update Regarding Versions of Standards Adopted Under HIPAA
• Preparing for the Version 5010 Upgrade: Vendor Involvement