HIPAA ASC X12 version 5010 and NCPDP version D.0 are new sets of standards that regulate the electronic transmission of specific healthcare transactions, including eligibility, claim status, referrals, claims, and remittances. Covered entities, such as health plans, healthcare clearinghouses, and healthcare providers, are required to conform to the new transaction set standards.  HIPAA Version 5010 will allow transition of the healthcare industry to ICD-10 codes on October 2013.

All covered entities have to be fully compliant on January 1, 2012. 

Resources:

• CMS Resources on 5010

• CMS Q&A’s related to HIPAA 5010

• CGS - HIPAA 5010 and the ICD-10-CM/PCS Implementation

• NHIC, Corp - Health Insurance Portability and Accountability ACT (HIPAA) HIPAA 5010A1/D.O information

• NGS - Version 5010 Implementation

• Palmetto, GBA – 5010 Deadline