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ICD-10 troubles AMA, moves ahead nationally and at CareOregon

ICD-10 troubles AMA, moves ahead nationally and at CareOregon

This fall, the American Medical Association made news when its House of Delegates voted to oppose the adoption of the new ICD-10 diagnosis coding set. The Centers for Medicare & Medicaid Services (CMS) requires a transition to ICD-10 by October 2013, and has not indicated that the date will change.

CareOregon will continue to move ahead with adoption and to encourage its network of providers to do the same, says Rebecca Fortuine, a member of the CareOregon ICD-10 implementation team.

The most immediate step is the change in electronic communication protocol coming up Jan. 1, 2012.

Electronic communication between providers, payers and CMS requires a format that is consistent and secure. Currently, the HIPAA billing system, designated 4010, includes fewer characters than are required by ICD-10. In January, health plans and providers switch to the newer 5010 billing system.

CareOregon is now sending and receiving 5010 transactions and is continuing to test.

“If any provider is ready to test, please e-mail us at, and we’ll help you get started” Rebecca says.

Although the deadline for moving to 5010 is Jan. 1, CMS will not begin enforcing the requirement until March. In the meantime, providers still using 4010 for CareOregon claims will still have their claims processed as before. All claims go through the Emdeon clearing house, which can convert the information from the 4010 format to the new 5010 format.

On the afternoon of Feb. 9, 2012, CareOregon will have a forum on ICD-10. For more details, send a request for information to:

For more about CareOregon’s implementation of 5010 transactions, please see the FAQs page on the website.