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ICD-10, 5010 and National Provider Identifier (NPI)

HHS Adopts 1-Year Delay of ICD-10 Compliance Date – New Date 10/1/2014

On August 24, 2012 the Department of Health and Human Services (HHS) announced adoption of a 1 year delay of the ICD-10 compliance date, from Oct. 1, 2013 to Oct 1, 2014. We will maintain our current momentum on our ICD-10 program work, including remediation of our impacted systems and vendor tools, affected business processes and policies. Based on this announcement, we plan to be fully ready to process ICD-10 claims by 10/1/2014.

Press Release

The proposed rule

We strongly encourage you to continue working toward compliance and to use this one year extension to address any business or system challenges you may experience. We do not anticipate any additional delay in the compliance. It is important that providers contact their billing or software vendor to understand their plans for conversion and testing. We will conduct targeted ICD-10 testing in advance of the new compliance date and will contact directly those entities involved.

Going forward, we will continue to use this site to share detailed information about our approach to ICD-10. This is the most current source of information and will be updated throughout the next several years as work continues on this important project.

We will continue to follow HHS and CMS guidance and work closely with the medical community to monitor compliance and manage risk.




HIPAA 5010 transaction set upgrade and the ICD-10 conversion

On January 16, 2009, Department of Health and Human Services (HHS) released two final rules under the Administrative Simplification Provision of the Health Insurance Portability and Accountability Act (HIPAA) that will facilitate nationwide transition to an electronic health care environment through adoption of:

  • Updated standards for electronic health care and pharmacy transactions (5010/D.0) – effective January 1, 2012
  • New diagnosis and procedure coding standards (ICD-10-Clinical Modification (CM) and ICD-10-Procedure Coding System (PCS) – effective October 1, 2014

The covered entities who must comply with the transaction and new coding standards are health care providers, health plans and health care clearinghouses.

We currently conduct electronic provider transactions exclusively in the HIPAA mandated version 5010. We plan to meet all applicable timeframes required to adopt the ICD-10 code set upgrades as established by Health and Human Services. We are actively engaged in the planning and execution stages for all aspects of the program.

ICD-10 Milestones and Timeline

ICD-10 Overview for Medical Professionals

NPI Overview for Medical Professionals