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National HIPAA Audioconference: Analysis of Proposed Rules Regarding Transactions/Code Sets and the ICD-10

Wednesday. September 3, 2008
1:00 pm - 3:30 pm (Eastern)
12:00 pm - 2:30 pm (Central)
11:00 am - 1:30 pm (Mountain)
10:00 am - 12:30 pm (Pacific)


President, Margret\A Consulting, LLC, Adjunct Faculty in Health Informatics, College of St. Scholastica, Schaumburg, IL

Gary A. Beatty
President, EC Integrity, Inc., Past Chair, X12N Insurance Subcommittee, Stewartville, MN

Jim Daley
HIPAA Program Director, Blue Cross Blue Shield of South Carolina, Columbia, SC

Rachel Foerster
Founder, Rachel Foerster & Associates, Ltd., Senior Consultant, Boundary Information Group, Beach Park, IL

Lynne Gilbertson
Vice President, Standards Development, National Council for Prescription Drug Programs, Scottsdale, AZ

Stanley Nachimson
Principal, Nachimson Advisors, LLC, Former Senior Technical Advisor for HIPAA, Centers for Medicare and Medicaid Services, Department of Health and Human Services, Washington, DC

James D. Whicker
Director of EDI, Intermountain Health Care, Chair, WEDI, Salt Lake City, UT

Steven S. Lazarus, PhD, CPEHR, CPHIT, FHIMSS
President, Boundary Information Group, Member, Board of Examiners, Health IT Certification, LLC, Past Chair, WEDI, Denver, CO (Moderator)

The Audioconference agenda is set forth in Eastern Daylight Time below:
1:00 pm Introduction and Significance of these Two NPRMs: Overview and Timeline and Compliance Dates
Steven S. Lazarus, PhD (Moderator)
1:10 pm The X12 837 Claims and 835 Remittance Advice: Changes from 4010, Improvements and Issues to be addressed
Gary A. Beatty
1:25 pm The X12 270/271 Eligibility and Benefits Inquiry and Response: Changes from 4010, Improvements, Relationship to CORE Phase I and Phase II and Issues to be addressed
Rachel Foerster
1:40 pm The NCPDP Transaction Modifications and New Transactions: NCPDP Telecommunication Standard Version (D.0) and Equivalent Batch Standard, Version (1.2) for Retail Pharmacy Transactions; NCPDP Medicaid Pharmacy Subrogation, Version 3.0; and NCPDP Telecommunications Standard D.0 and ASC X12 Version 5010 for Billing Retail Pharmacy Supplies and Services
Lynne Gilbertson
1:55 pm The Changes from ICD-9 and the Challenges: ICD-9 to ICD-10 The Major issues; ICD-10 NPRM Summary; and Issues to be addressed
Margret Amatayakul, MBA
2:10 pm The WEDI/NCHICA Planning and Implementation Timeline: Industry Considerations Prior to the NPRMs Publication; Comparison of the Industry Anticipated Timeline and the Proposed Regulations Timeline and Issues to be Addressed
Stanley Nachimson
2:25 pm Provider Perspective: Anticipated Benefits; Concerns; Alternative Approaches to the Concerns; and Timeline and Budgeting for Implementation
James D. Whicker
2:40 pm Health Plan Perspective: Anticipated Benefits; Concerns; Alternative Approaches to the Concerns; and Timeline and Budgeting for Implementation
Jim Daley
2:55 pm Beyond the Transactions - Implementation Challenges: Provider Billing and EHR Systems, Training, and Management Issues; Health Plan EDI Systems, Disease Management, Reimbursement schedule calibration and Management Issues; Data Warehouse Data conversion/Mapping; and Health Information Exchange Implications
Steven S. Lazarus, PhD
3:10 pm Discussion and Q & A
Steven S. Lazarus, PhD (Moderator)
3:30 pm Audioconference Adjournment


On Friday, August 15, the Department of Health and Human Services issued a proposed regulation to replace the ICD-9-CM code sets now used to report healthcare diagnoses and procedures with substantially expanded ICD-10 code sets which are to become effective on October 1, 2011. In a separate proposed regulation, DHHS has also proposed adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as healthcare claims. Comments on both proposed rules are due by 5:00 pm Eastern time on October 21, 2008.

Click here to review the ICD-10 code sets proposed rule and the updated transaction standards proposed rule.


The Workgroup for Electronic Data Interchange (WEDI) will conduct a Policy Advisory Group (PAG) Forum to address the NPRMs for Electronic Transaction Standards X12 5010, NCPDP D.0 and NCPDP 3.0 and the Medical Data Code Set Standards ICD-10 on September 9-11, 2008 at the Marriott at Fairview Park in Northern Virginia. Attendees can fly into either Washington National Airport (15 miles) or Washington Dulles (20 miles). More details on the program agenda, including registration and hotel information, will be posted to the WEDI website, www.wedi.org, by Friday morning, August 22. Please hold these dates on your calendar.

This National HIPAA Audioconference has been approved for 2 CE clock hours for fulfilling the continuing education requirements of the Health IT Certification CPEHR, CPHIE and CPHIT programs.

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