5010 Update to the HIPAA Electronic Transaction Standards

November 28, 2011 by Wellons Communi...

As a valued NCG Medical client, we want to assure you that you are prepared for the upcoming 5010 transaction requirements. The NCG Support Team will contact your office prior to the deadline to perform the necessary update for 5010 transactions.  

Begin preparation for the update by reviewing the information below and updating your Perfect Care system accordingly.  Please feel free to contact us with any questions at 800-330-1906 or email at questions@ncgmedical.com.


What is 5010A1 and How Do You Prepare?

If you submit electronic healthcare transactions, such as filing a claim, checking a patient’s eligibility, or receiving remittance advice you should be aware of the 5010 update to the HIPAA electronic transaction standards. 5010 is the nickname for the Version 005010 specification created by the Accredited Standards Committee (ASC) and approved by the Department of Health and Human Services for Implementation.

Essentially, 5010 is an upgrade to the way insurance payers can receive information and better exchange information about the patients you see. The upgrade also allows for the larger field size of coming ICD-10 codes as well as other improvements.


What Do I Need to Do?

In preparation, please ensure you have the correct 9-digit zip codes entered in your Perfect Care system for practice, provider and facilities.  The website below may be used to verify address zip codes through the U.S. Postal Service.



Quick Reference Full 9-Digit ZIP Code Required:

2010AA Billing Provider
2310C Service Facility Claim Level
2420C Service Facility Line Level

Note: All other ZIP Codes may be sent in the 5 or 9 digit format.

The Billing Provider Address (2010AA loop for ANSI claims) will require a physical location address to be reported in 5010A1 claim files. Post Office (P.O.) box and lockbox addresses cannot be reported as a Billing Provider Address. If you would like to send a P.O. Box or lockbox address, it must be reported as a Pay-to Address (2010AB loop for ANSI claims). The Pay-To Provider address is only needed if it is different than the one being used for the Billing Provider.  Our support team will assist you with this configuration at the time of your update.

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