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Electronic Billing & EDI Transactions

5010 - D.0

HIPAA Standards

The Medicare Fee-for-Service program is evaluating the impact of implementing the next version of the X12 and NCPDP standards which may be proposed for adoption under HIPAA in the future. In consideration of the possibility that the Secretary might adopt a new version of the HIPAA standards, Medicare, as a health plan, has completed a gap analysis of those standards. Medicare has prepared a comparison of the current X12 HIPAA EDI standards (Version 4010/4010A1) with Version 5010 and the NCPDP EDI standards Version 5.1 to D.0, and is making these side-by-side comparisons available to other covered entities and their business associates.

 

Downloads
Professional Claim 837-P 4010A1 to 5010 Side by Side [PDF, 442KB]
Institutional Claim 837-I 4010A1 to 5010 Side by Side [PDF, 372KB]
Remittance 835 4010A1 to 5010 Side by Side [PDF, 91KB]
Claim Status 276/277 4010A1 to 5010 Side by Side [PDF, 179KB]
Eligibility 270/271 4010A1 to 5010 Side by Side [PDF, 242KB]
NCPDP 5.1 to D.0 Side by Side [PDF, 28KB]
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Page Last Modified: 05/02/2008 12:05:54 PM
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