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5010 Transition 

Select the Frequently Asked Question to view answer.

If after reviewing these FAQs, you still don’t find the answers you seek, all inquiries should be submitted to the HFS Webmaster.

  1. What is the compliance date for Version 5010 and Version D.0?

    The federal mandatory compliance date is January 01, 2012.

  2. When will testing begin at Healthcare and Family Services (HFS)?

    Test and transition time frames are currently being established for each HFS claimant type, i.e., Rev Vendors, sister agencies, Dentaquest, etc. Watch for updates in the future.

  3. Who will be allowed to test?

    Clearinghouses and vendors who are directly connected to HFS will be allowed to test with the department. Testing with individual providers will not be possible at this time.

  4. Will ICD-10 be implemented at the same time with 5010 and D.0?
    No. The 5010 implementation has to be completed prior to the ICD-10 implementation. Per the Federal mandate, claims with ICD 10 codes will be accepted by HFS on claims with Dates of Service after October 1, 2013. Hospital Inpatient claims will be based on date of discharge on/after October 1, 2013.
  5. Will HFS create and publish companion guides prior to implementation of 5010?
    Companion Guides will be added to the Web site as they become available thru 2011. Check the EDI Web page routinely for updates.
  6. What is the implementation strategy for converting all transactions?

    The HIPAA team is targeting to complete the 837I, 837P, 837D, and NCPDP transactions first and then will focus on the other transactions.

  7. How will the 5010 transactions impact MEDI/IEC?
    The MEDI/IEC system will be upgraded to accept both 5010 and 4010 files. HFS will continue to accept 4010 files until January 2012. HFS' implementation strategy is to have the capability to accept 5010 claim files ready by September 15, 2011. The ability to accept 5010 Claim Status and Eligibility transmissions will be implemented after October 1, 2011.
  8. Will there be a period where HFS will be accepting both a 4010 format and a 5010 format?

    HFS' implementation strategy is to have a dual use period. During this time frame, HFS will accept both formats. Targeted start date for the claim transactions is September 15, 2011.

  9. Will HFS be implementing the Errata to the TR3 guides?

    For those transactions that have an Errata mandated, the Errata version is the only one that HFS will test and implement.

  10. Which transaction acknowledgements do you intend to support?

    HFS will continue to respond to transactions submitted in a 4010 format with the 997 and 824 acknowledgements. Transactions submitted in the 5010 format will be acknowledged with the 999 and 824. Please See Companion Guides for further information.

  11. When will HFS no longer accept 4010 versions of the HIPAA transactions?

    Plans are to continue accepting 4010 transmissions thru December 2011.

  12. When will HFS start using the 5010 version of the 835 transaction?

    The process to switch to the 5010 version of the 835 transaction will be implemented on January 1, 2012. Until that time, HFS will continue using the 4010 version of the 835.

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