Medicare Fee-For-Service Version 5010 July 1, 2012 Implementation Update for the Week of July 2, 2012
In its continuing effort to help trading partners transition to the new versions of standards adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) for electronically exchanging health care transactions, Medicare Fee-For-Service (FFS) has the following updates for the week of July 2, 2012:
- Business Partner Confirmation for Version 5010
- Claims (837) Rejection Error Messag
- Remittance Advice (835) Closeout Activities
Business Partner Confirmation for Version 5010
Have you confirmed that your business partner has converted to version 5010 on your behalf? By now all providers should have contacted their clearinghouses, billing services, or vendors that they use to electronically submit Medicare FFS claims to ensure that as of July 1, 2012 all of your claims will be submitted in version 5010. Please contact your clearinghouse, billing service, or vendor before calling your Medicare Administrative Contractor's (MAC's) EDI helpdesk to search for your claims and confirm your transition to version 5010.
Claim (837 I and P) Rejection Error Message
Since June 29, all Medicare FFS claims must be sent as Accredited Standards Committee (ASC) X12 Version 5010 or NCPDP D.0. Any Medicare FFS claims received in version 4010 format after normal close of business on June 29 are being rejected back to the submitter. The specific message received if a claim is rejected depends on your specific MAC. A detailed list of 4010 rejection error messages by MAC may be found on the Important 4010 - 5.1 Rejection Information Web page.
Remittance Advice (835)
Medicare FFS has stated in previous communications that trading partners would be allowed an additional 30 days to complete the 835 remittance advice transaction transition. Medicare FFS' internal processes related to closeout activities for the 835 remittance transaction include the generation of the last ASC X12 Version 4010A1 835 data on July 31, 2012. Remittance Advice files from the last processing cycle will be available for retrieval upon conclusion of the July 31, 2012 batch cycle. Beginning August 1, 2012, the Medicare FFS program shall only produce the 835 remittance advice transaction in the ASC X12 Version 5010.
For more information on ASCX12 Version 5010 and NCPDP Version D.0, please visit the Versions 5010 and D.0 Web site.
Post Date 07/05/12