https://immattersacp.org/weekly/archives/2012/06/05/9.htm

Version 5010 compliance deadline is approaching

The enforcement discretion period for all HIPAA-covered entities to complete their upgrade to the version 5010 electronic standards ends on June 30.


There are a few things to keep in mind for submitting version 5010 claims. These tips could help practices avoid unnecessary rejections:

  • ZIP code: A complete 9-digit ZIP code must be included for the billing provider and service facility location.
  • Billing provider address: A physical address must be used for the billing provider address. (The pay-to address can still be a post office box.)
  • National Provider Identifier (NPI): For version 5010 claims, clinicians are only allowed to report an NPI, not a Social Security or tax ID number, as a primary identifier.

Additional details about these version 5010 tips are available on ACP's website.