|
All health plans, clearinghouses, and providers who choose to submit or receive transactions electronically, are required to use the HIPAA National Standards for Electronic Transactions and to use certain Code Sets within those Transactions. The original Transactions & Code Sets Final Rule, dated August 17, 2000, adopted American National Standards Institute (ANSI) Accredited Standards Committee (ASC) X12N (Version 4010) and National Council for Prescription Drug Program (NCPDP) (Version 5.1 & 1.1) standards for eight types of administrative transactions.
On January 16, 2009 The Department of Health and Human Services (HHS) published the Modifications to HIPAA Electronic Transaction Standards Final Rule which adopted updated versions (X12 Version 5010 and NCPDP Version D.0 and 1.2) of the standards that were adopted in 2000.
The 2009 Final Rule also adopted standards to be used for Medicaid Pharmacy Subrogation and billing retail pharmacy of professional services and retail pharmacy supplies. The compliance date for use of the updated versions was January 1, 2012.
Click here for a link to obtain the Version 5010 X12 HIPAA Standards /Implementation Guides.
Click here for a link to obtain the NCPDP Versions D.0 and 1.2 Implementation Guides.
|
