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HIPAA: 5010/NCPDP D.0 & 1.2
On January 16, 2009, the Secretary of the Department of Health and Human Services (DHHS) published the final rule for ASC X12 version 5010 and National Council for Prescription Drug Program (NCPDP) version D.0, the next HIPAA standard for HIPAA covered transactions, with an implementation date of January 1, 2012. The new HIPAA ASC X12 version 5010 improves the standards for electronic transactions from the ASC X12 version 4010 standards, while NCPDP version D.0 improves upon the NCPDP version 5.1 standards for pharmacy and supplier transactions. The transition to HIPAA 5010 is anticipated to have specific impact on: Claims and encounters; enrollment in healthcare stimulus plans; authorization, request, referral and response; payment/remittance advices; payment of premiums; eligibility requests; and inquiries related to the status of submitted claims and their responses. Additionally, HIPAA 5010 has been created in such manner that the forthcoming changes in the revised medical billing/coding data of ICD-10-CM & ICD-10-PCS will be accommodated by all covered entities in a better manner. The new HIPAA NCPDP version D.0 will provide the ability to support new-use cases brought forward by the industry; clarification of usage to remove ambiguity; consistency across transactions; and removal of data content that is no longer used.
The documents available on this page are updated on an ongoing basis to ensure that they contain the most up-to-date information. Providers and submitters are therefore encouraged to bookmark (CTRL+D on Windows or Command+D on Mac OSX) this page and refer to it often for the most current documents.
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Articles
- POS Device Update Underway for HIPAA ASC X12N v.5010A1 Compliance
- 270 Real-Time and Batch Eligibility Transaction Testing Instructions Update
- Updated HIPAA 5010 Medi-Cal Companion Guide
- HIPAA 5010 Medi-Cal Companion Guide Update
- CMC Billing and Technical Manual Update
- HIPAA 5010 Companion Guide Updated
- HIPAA: Voluntary Disclosure Process to Refund Overpayment of 837I Electronic Claims
- HIPAA: ASC X12N 837 v.5010 Issue with Attending/Rendering Provider
- HIPAA: NCPDP Payer Sheet Update 5.0
- HIPAA 5010 Companion Guide Version 1.3 Update
- HIPAA 5010 Anesthesia Billing Update
- Instructions on Submitted Share of Cost Information for 837I Transactions
- CMC Developers, Vendors and Billing Services Directory Update
- HIPAA 5010: Top 10 Claim Rejections for CMC Transmissions
- Important Notice About 835 Remittance Advice
- 270 Real-Time Eligibility Transaction Testing Instructions Update
- 270 Batch Eligibility Transaction Testing Instructions Update
- NCPDP D.0 and 270 Real-Time – Testing and Certification Update
- ASC X12N 5010 and NCPDP 1.2 – Testing Update
- CMC Billing and Technical Manual Update: New Sections and Supplemental Materials
- Now Available: Updated IPCS User Guide, IPCS Tutorial and RTIP Tutorial