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Bill Osuch - Random geek notes

If you're working with healthcare EDI transactions in BizTalk, then you need to be thinking about the upcoming 5010 transaction set implementation. In a nutshell, the 5010 transaction set introduces anywhere from dozens to hundreds of changes (depending on the individual transaction) and paves the way for the upcoming ICD-10 implementation.

The timeline for transition is as follows:

Jan 2009 Begin Level 1 activities (gap analysis, design, and development)
Jan 2010 Begin internal testing for HIPAA 5010 and NCPDP D.0
Dec 2010 Achieve Level 1 compliance (covered entities have completed internal testing and can send and receive compliant transactions)
Jan 2011 Begin Level 2 testing period activities (external testing with trading partners and move into production; dual 4010A/5010 processing mode) & begin initial ICD-10 compliance activities (gap analysis, design, development, and internal testing)
Jan 1, 2012 5010/D.0 compliance date for all covered entities
Oct 1, 2013 The compliance date for ICD-10-CM and ICD-10-PCS

In other words, you may have a trading partner wanting to start testing with you as early as January! (Then again, you may not... I know from experience that many organizations are attempting to sign agreements with their trading partners to continue accepting the 4010A1 format past 2012).

The first step in converting your BizTalk processes is to download the new set of schemas. They are available in a hotfix located at:

This hotfix also contains some replacement DLLs, so if you're just wanting to grab the schemas and not do an upgrade you'll need to press cancel on the hotfix's splash screen, then manually run the file C:\HIPAA5010 Support\ENU\MicrosoftEdiXSDTemplatesKb973415.exe. Your extraction path may vary, of course...

Posted on Thursday, October 7, 2010 12:52 PM BizTalk , 5010 | Back to top

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