Business Intelligence

HIPAA 5010 and ICD-10: The Road to Compliance

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Executive Summary

Healthcare payers and providers are facing two major compliance initiatives over the next couple of years: conversion from the HIPAA 4010 electronic transaction set to the 5010 set and conversion from ICD-9 codesets to ICD-10. These initiatives will impact nearly every core process, system and interface across the industry, and industry costs are expected to be in the billions of dollars. Although healthcare stakeholders are facing 2012 and 2013 regulatory deadlines, few have begun actively planning for conversion. Industry research has shown that many organizations are still in the information gathering phase, trying to assess potential impacts on themselves, their vendors and business partners.

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