Payment Alert! 5010 is Here. Are you ready?
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IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.
Content provided on this page contains outdated information and instruction and should not be considered current. CGS is providing this archived information for research purposes only. This archived section contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

March 8, 2012

Payment Alert! 5010 is Here. Are you ready?

You must comply with this important deadline to avoid delays in payments for Medicare Fee-For-Service (FFS) claims after March 31, 2012. You and your billing and software vendors must be ready to begin processing the Health Insurance Portability and Accountability Act (HIPAA) Versions 5010 & D.0 production transactions by March 31, 2012. Beginning April 1, 2012, all electronic claims, eligibility, and claim status inquiries MUST use Versions 5010 or D.0. Version 4010/5.1 claims and related transactions will no longer be accepted. The electronic remittance advice will only be available in the 5010 version. Paper submissions are not an option!

Visit the 5010 Companion documents for step by step directions on how to test at http://www.cgsmedicare.com/partb/edi/pdf/5010_Companion.pdfPDF.

To be ready you can receive the free Version 5010 software (PC-Ace Pro32) at http://www.cgsmedicare.com/parta/edi/index.html and begin testing now.

For HHH and Part A, you may download the free PC-Print software to view and print compliant HIPAA 5010 835 remittance advices. A PC Print Quick Start Job Aid for Remittance Advice is available at http://www.cgsmedicare.com/parta/edi/pdf/PCPrintQuickStartJobAid.pdfPDF. Contacting a Version 5010 compliant clearinghouse who can translate the non-compliant transactions into compliant 5010 transactions is another option.

For Part B you can also download the free Medicare Remit Easy Print (MREP) software to view and print compliant HIPAA 5010 835 remittance advices, which are available at https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/AccesstoDataApplication/index.htmlExternal Websiteon the CMS website.

Prepare now and be ready for the April 1st, 2012 deadline.


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