Implementation of 5010 Transaction Standards

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The South Carolina Department of Health and Human Services (SCDHHS) will begin processing 5010 transactions January 1, 2012, as mandated.

On November 17, 2011, the Centers for Medicare and Medicaid Services (CMS) announced a 90-day delay in enforcement of the new 5010 transactions standards. Although enforcement of compliance to ASC X12 5010 Version 5010 and NCPDP D.0 was delayed until March 31, 2012, the mandatory compliance date remains January 1, 2012.

Implementation Schedule and Important Dates:

 

Date

Description

December 29, 2011, 6:00pm

Last day to submit transactions in 4010 format

December 30, 2011

Final 4010 outbound transactions

January 1, 2012

Trading Partners start submitting 5010 claims

January 3, 2012

First claims processing run with 5010 claims

January 6, 2012

835 in 4010 format

January 13, 2012

835 delivered in 5010 format

 

All active Trading Partners should coordinate testing of 5010 transactions with the SCDHHS Electronic Data Interchange (EDI) Support team.

 

Beginning January 1, 2012:

 

  • Trading partners that are not configured in 5010 submission tables will have their transactions rejected. 
  • Transactions submitted in 4010 format will be rejected. 

 

Any Trading Partner that feels its readiness is in jeopardy must contact the EDI Support team immediately by email at EDIG.OPS-MCAID@palmettogba.comor 888-289-0709.

 

The SCDHHS web site has all information related to the 5010 transition.  This includes:

 

  • Companion Guides
  • New Trading Partner Agreement Forms and Instructions
  • General Project Information
  • EDI Support Hours During 5010 Transition

 

This information can be found at http://www2.scdhhs.gov/resource/hipaa-5010-project-status.

 

Thank you for your continued support of the South Carolina Healthy Connections Medicaid Program.  

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