HIPAA News

HHS Supports ASC X12 Standards, to Advance Electronic Health Care Environment

(Aug 21, 2008)-- The Department of Health and Human Services (HHS) released the much-anticipated Notice of Proposed Rule Making (NPRM) for the adoption of Accredited Standards Committee (ASC) X12 version 005010 transactions enhancements, pertaining to Health Insurance Portability and Accountability Act (HIPAA) transactions. The new ASC X12 version 005010 standard is key in the use of the larger International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for diagnosis codes and also the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedures, proposed under the new rule.

"The new 005010 transaction standards are essential in implementing the ICD-10-CM codes and lead promise to a health care system focused on improved efficiency and accuracy, reduced costs and expanded care," said Dan Kazzaz, Chair of ASC X12. "X12 members who developed the 005010 standards see the magnitude of this effort and are dedicated to improving health information technology."

Under the updated transaction standards proposed rule, compliance with ASC X12 version 005010 would be required by April 1, 2010, according to HHS. This rule affects HIPAA-covered entities, such as health plans, health care clearinghouses and health care providers.

Comments on the updated, proposed 005010 transaction standards are due by 5 p.m. Eastern time, October 21, 2008, and comments on the proposed ICD-10 code sets rule are due by 5 p.m. Eastern time, October 21, 2008.

Industry education of the codes is critical in the movement towards a nationwide electronic health care environment. Twelve 005010 transactions are embodied in nine ASC X12 Implementation Guides, known as Technical Reports Type 3 (TR3s) and are now available individually and as a suite at www.x12.org. The transactions include:

-- 270/271: Health Care Eligibility Benefit Inquiry and Response
-- 276/277: Health Care Claim Status Request and Response
-- 278/278: Services Review Request for Review/Response
-- 820: Payroll Deducted and Other Premium Payment
-- 834: Benefit Enrollment and Maintenance
-- 835: Health Care Claim Payment/Advice
-- 837P: Health Care Claim: Professional
-- 837I: Health Care Claim: Institutional
-- 837D: Health Care Claim: Dental

The ASC X12 Insurance subcommittee's HIPAA Implementation Coordination work group also presented an educational webinar series detailing how X12 version 005010 transactions address industry-requested requirements.

Please visit www.cms.hhs.gov/TransactionCodeSetsStands/02_TransactionsandCodeSetsRegulations.asp#TopOfPage to view the regulations.

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