On January 15, the Department of Health and Human Services (HHS) announced two final rules that will facilitate the ongoing transition to an electronic health care environment through adoption of a new generation of diagnosis and procedure codes and updated standards for electronic health care and pharmacy transactions.
The first rule adopts the ICD-10 code sets to replace the ICD-9-CM code sets used to report health care diagnoses and procedures in electronic health care transactions. The new codes sets, known as ICD-10-CM/PCS, are expanded and more precise. The final rule set the compliance date at October 1, 2013, which is two years later than proposed.
The second rule adopts standards that covered entitities must use in electronically conducting certain health care administrative transactions. The current versions of the standards, the Accredited Standards Committee X12 Version 4010/4010A1 for healthcare transactions, and the National Council for Prescription Drug Programs Version 5.1 for pharmacy transactions, are widely recognized as outdated and lacking certain functionality. The final rule replaces the current versions with Version 5010 and Version D.0, respectively. The date for implementation will be January 1, 2012.
The final rule can be accessed under Health and Human Services (HHS) at http://www.access.gpo.gov/su_docs/fedreg/a090116c.html.