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

HHS to Publish Rule to Adopt 005010 Standards Transactions Enhancements on August 22, 2008

FALLS CHURCH, VA–(EMWNews – August 19, 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. The

last of the six-part webinar series will take place on Thursday, August 21,

2008 (835 – Health Care Claim Payment/Advice). Each session is also

available at www.X12.org/webinars via streaming Internet playback.

Please visit

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

About ASC X12

The Accredited Standards Committee (ASC) X12, chartered by the American

National Standards Institute (ANSI) in 1979, develops electronic data

interchange (EDI) standards and related documents for national and global

markets. With more than 315 X12 EDI standards and a growing collection of

X12 XML schemas, ASC X12 enhances business processes, reduces costs and

expands organizational reach. ASC X12’s diverse member base includes 3,000+

standards experts representing over 340 companies from multiple business

domains. To learn more about ASC X12 and how to participate in its vital

standards-setting role for health care, insurance, transportation, finance,

government and many other industries, visit www.disa.org, or call

703-970-4480.

About DISA

The Data Interchange Standards Association (DISA) is home for the

development of cross-industry e-business interchange standards that help

individuals and organizations improve business processes, reduce costs,

increase productivity and take advantage of new opportunities. Driving an

array of e-business initiatives, DISA provides administrative and technical

support to the Accredited Standards Committee X12. For additional

information about DISA, visit www.disa.org, or call 703-970-4480.