HIPAA 5010 – more than just the pre-requisite for ICD 10!
I wish experts gave HIPAA 5010 the credit it deserves as an independent endeavor to improve EDI and reduce cost of healthcare. Positioning HIPAA 5010 mainly as the “pre-requisite” for ICD 10 is turning organizations’ focus away from implementing 5010 as an improvement measure.
HIPAA 5010 has more than 1,000 unique changes and only a few of them are targeted to accommodate the expanded ICD codes. Of course there will be additional clinical information available on the HIPAA 5010 file format, but that’s not all. Take for instance 5010’s ability to better handle “Coordination of Benefits” or the new codes to support additional paperwork information available at the provider’s office – these can be used to improve the effectiveness of EDI in claims processing.
Moreover, HIPAA 5010 standards were developed based on industry feedback on the shortcomings of 4010. Some HIPAA transactions are currently used 20% or less number of times and the interactions between trading partners are still manual. There is significant opportunity for improvement. By viewing 5010 as an opportunity beyond just the pre-requisite for ICD 10, the healthcare industry will move towards improved EDI – it might not be able to address all the current shortcomings, but it will surely be one more right step towards reducing the cost of healthcare.
