DMAP now exchanges all health care transactions in the 5010 and NCPDP 1.2/D.0 formats, and plans to end support of older formats for ALL transactions by Mar. 30, 2012.

In order to continue to successfully exchange transactions with DMAP, all trading partners must do all of the following by Mar. 1, 2012:

1) Submit a completed Oregon Medicaid 4010 Request Form listing all transactions requiring 4010 support (including the 837);
2) Register all listed transactions for 5010 testing with DMAP using the EDI Registration Change Form (Exhibit C); and
3) Begin third party testing with DMAP for all registered transactions.

On Mar. 1, 2012, DMAP will end 4010 mailbox access for any trading partners who have not taken these three steps. After Mar. 1, any trading partners who lost 4010 mailbox access must take these three steps to get their 4010 mailbox access restored. On Apr. 1, 2012, DMAP will end all 4010 mailbox access and only exchange 5010/NCPDP 1.2 transactions through the 5010 mailboxes.

On Oct. 1, 2013, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. All health care claims with dates of service on or after this date must use the ICD-10 code sets.

If you bill DMAP or an OHP managed care plan for services to OHP clients, this means:

• If you haven't already, make sure your billing system complies with HIPAA 5010 standards and DMAP's specific billing requirements. You have until Mar. 31, 2012 to become 5010 compliant. Learn more at www.oregon.gov/OHA/edi/5010.shtml.

• If you are already 5010-compliant, make sure your processes and systems for medical records and coding use the ICD-10 code sets by Sep. 30, 2013. You will still use the ICD-9 code sets to bill for dates of service prior to Oct. 1, 2013.

Right now, eligible health care providers in Oregon can apply for incentives to help implement and meaningfully use electronic health records in their clinics.

Since the Medicaid EHR Incentives Program started in late September, over $55 million in federal incentive payments have been paid to Oregon Medicaid hospitals and eligible professionals.

If you would like to apply for 2011 incentive payments:

-- Register on the federal incentive program Web site;
-- Make sure you have Provider Web Portal access to the "EHR incentive" screen. This may require you to enroll as a DMAP provider if you haven't already;
-- Collect patient volume data that shows you meet Medicaid EHR incentive program criteria;
-- Apply on the Provider Web Portal by Feb. 29, 2012.

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