In order to submit electronic transactions with ICD-10 codes, you must use Version 5010 of the HIPAA electronic transaction standards. The previous version (4010) can’t accommodate the longer ICD-10 codes. Now, before you get too concerned about adding yet another task to your ever-growing to-do list, let me remind you that you probably already made this switch back in 2012. If you didn’t, though, you need to do so now. Providers who are still using an outdated version are in violation of HIPAA—and we all know that HIPAA violations can be costly.
According to CMS, if you aren’t sure you are Version-5010 compliant, you should check with your health IT professional, clearinghouse, or billing service. If you use the WebPT Billing Service, you’re good to go; we transitioned to Version 5010 years ago.
To learn more about Version 5010 HIPAA standards, check out the Version 5010 Resources on this CMS page. If you are experiencing problems with the updated version, you can use this tool to report them and to search a database of known issues.