HIPAA 5010 and ICD10

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HIPAA 5010 AND ICD-10

International Classification of Diseases (ICD-10)

On April 1, 2014 the president signed a bill into law that addresses a variety of health policy issues, including a delay in the transition from ICD–9 to ICD–10 code sets. The new code set will not be adopted until 10/1/2015. We will continue to monitor any industry changes related to this law. We'll also keep you informed as we decide how the law will affect our planning and work.


On January 15, 2009, the Department of Health and Human Services (HHS) released two final rules under the Administrative Simplification Provision of the Health Insurance Portability and Accountability Act (HIPAA) that will facilitate the United States’ ongoing transition to an electronic health care environment through the adoption of:
  • Updated standards for electronic health care and pharmacy transactions (5010) – effective January 1, 2012.
  • New diagnosis and procedure coding standards – that is, the ICD-10-Clinical Modification (CM) and ICD-10-Procedure Coding System (PCS) – effective October 1, 2013. A revised compliance date of October 1, 2014 (ICD-10, 5010 and National Provider Identifier (NPI) was proposed on April 9, 2012.
The covered entities who must comply with the transaction and new coding standards are health care providers, health plans and health care clearinghouses.

The scope for ICD-10 remediation includes more than 100,000 new diagnosis and procedure codes which will allow for greater specificity about the services represented. The new codes are expected to meet the increased level of detail needed to recognize advancements in medicine and technology, and will bring the United States in line with the majority of the developed world. Concerns that the current ICD-9 terminology and classifications of some conditions are outdated and inadequate have been cited as the primary reasons for the conversion to ICD-10.

This is a unique and challenging time in healthcare. The implementation of ICD-10-CM/PCS in America is anticipated to improve the capture of healthcare information and bring the United States in step with the medical diagnosis coding systems worldwide.

ICD-10 Updates
Coventry ICD10 FAQs August 2015
Coventry’s response to CMS additional guidance July 2015
Coventry ICD10 testing and metric overview
Now Accepting Pre-Certifications for ICD-10

Coventry FAQ’s November 2014

New ICD-10 Compliance Date Set
HCFA 1500 Update



ICD-10 and HIPAA 5010 Document Library

ICD-10

Q3 2013
PDF I 147 KB
Status Update
Q2 2013
PDF I 139 KB
Status Update
Q1 2013
PDF I 45 KB
Status Update
Q3 2012
PDF I 121 KB
Status Update
Q1 2012
PDF l 72 KB
Status update
Q3 2011
PDF | 12 KB
Status update


HIPAA 5010

Q3 2012
PDF I 2 KB
Status Description
Q1 2012
PDF l 15 KB
Status update
Q3 2011
PDF | 20 KB
Status update