CMS to delay enforcing 5010 compliance

The CMS has backed off—a bit—from its Jan. 1, 2012 deadline for enforcement of a rule requiring adoption of a more-robust set of claims transmission standards.

The CMS announced today it will hold off until March 31, 2012, on enforcing its rule requiring hospitals, physician practices, health plans and claims clearinghouses to switch to using the ASC X12 Version 5010 standards for the electronic transmission of healthcare claims and other administrative communications. The Jan. 1 compliance deadline for Version 5010 will not be changed, however, according to the CMS' statement (PDF).

The agency said its decision to bend a little on enforcement was "based on industry feedback revealing that, with only about 45 days remaining before the Jan. 1, 2012 compliance date, testing between some covered entities and their trading partners has not yet reached a threshold whereby a majority of covered entities would be able to be in compliance by January 1."

The CMS also published a list of frequently asked questions.

The announcement comes after significant industry angst about lack of readiness to make the upgrade from the Version 4010 standards currently in use.

In June, following a survey of its members, the Medical Group Management Association called for the CMS to adopt a Plan B if the compliance outlook didn't improve dramatically.

Just two days ago, the American Medical Association's House of Delegates vowed to work against the mandated adoption, due Oct. 1, 2013, of the International Classification of Diseases, 10th Revision.

A switch to the more-robust Version 5010 standards is deemed to be a necessary precursor to adoption of ICD-10.