The U.S. congress enacted the HIPAA (Health Insurance Portability and Accountability Act) to improve overall health coverage through simplified health administrative transactions. This included added information security and privacy services along with electronic transactions that used secure codes. However, while the current rules governing these electronic transactions have standardized the use of industry code sets, individual companion guides are still used to address specific shortcomings. This has resulted in unnecessary complexity and difficulty in standardization.
The American Health Department recently issued a new 5010 standard that is expected to reduce individual guide requirements and promote consistent implementation across multiple parameters. It also enables the transmission of ICD-10 codes which was not possible with the previous versions. Further, the Health Department has now made compliance with ICD-10 code sets mandatory to report healthcare diagnoses and procedures.
The 5010 version is widely expected to define transaction standards more clearly with better instructions thereby eliminating ambiguity and redundancy in data content. The transition to the 5010 version is also expected to create significant savings in the healthcare industry through increased administrative and operational efficiency. Also the use of ICD-10 code sets with improved specificity on the diagnosis and procedure should boost reimbursement accuracy and deliver a higher quality of healthcare. This compliance issue, if approached strategically, can therefore provide immense value.
What do you think could be some of the benefits you can accrue by deploying 5010 and ICD-10? Share your opinions here!