Today, health care providers and plans use many different formats for submitting health care information electronically. On August 17, 2000, the final rule was issued for the following electronic transactions and code set standards. The first HIPAA final rule requires the use of American National Standards Institute, Accredited Standards Committee (ANSI ASC) X12N Version 4010 electronic transactions. Below is a list of these transactions and the corresponding ANSI ASC X12N Version 4010 identifying numbers.

HIPAA mandates standard code sets for electronic transactions, such as National Drug Codes (NDC), International Classification of Diseases (ICD-9) diagnoses codes,and Health Care Financing Administration Common Procedure Coding System (HCPCS) codes. All state-only and proprietary codes will no longer be allowed. The Department of Health Care Services is currently reviewing Medi-Cal-only HCPCS Level III codes and will notify providers of any future changes. Below is a list of approved national codes.

Approved Code Sets:

• ICD-9-CM diagnosis codes
• Current Procedural Terminology (CPT) (HCPCS level I)
• Current Dental Terminology (CDT)
• Health Care Financing Administration Common Procedure Coding System (HCPCS Level II)
• National Drug Code (NDC)

Additional standardization requirements for unique identifiers and security have not yet been finalized by the Department of Health and Human Services and may have significant impact to your organization.

Visit Medi-Cal's HIPAA Web site for HIPAA news and links to other HIPAA Web sites.

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 includes provisions for the simplification of administrative and financial health care transactions by standardizing the electronic exchange of information between health care plans, clearinghouses and providers.