X12 HIPAA versions 4010, 5010, and 5010 Errata
HIPAA 5010 expands HIPAA regulation to include electronic transmission of healthcare transactions, including eligibility, claim status, referrals, claims, and remittances. ASC X12 Version 5010 is the adopted standard format for transactions, except those with retail pharmacies.
HIPAA standard is used by physicians, clearinghouses, hospitals, pharmacies, payers, and dentists. Some of the most popular messages are 837P, 270, 271, 278, 276, 834, etc.
EDI Tools for .NET supports all transactions for the X12 HIPAA standard in versions 4010, 5010, and 5010 Errata.
A collection of ready-to-use X12 HIPAA templates is offered as part of the product, however, if a transaction is missing or needs to be modified, please contact us.
All HIPAA templates are also available in interactive view.
Additional X12 HIPAA resources:
- How to validate HIPAA SNIP Tiers
- How to validate HIPAA situational rules
- How to implement Electronic Visit Verification for 837P
- How to create databases for HIPAA 5010 transactions
The table below shows the X12 HIPAA templates for versions 4010, 5010, and 5010 Errata, which are available in EDI Tools for .NET. The "Message" column shows the transaction ID. The "4010", "5010", and "5010 Errata" columns list all available X12 templates in EDI Tools for .NET, and link to the interactive view of the template in EdiNation.
X12 HIPAA 270, 271, 276, 277, 278, 820, 834, 835, 837P, 837I, 837D
Message | Description | 4010 | 5010 | 5010 Errata |
---|---|---|---|---|
X12 270 | Eligibility, Coverage or Benefit Inquiry | 4010X092A1 | 5010X279 | 5010X279A1 |
X12 271 | Eligibility, Coverage or Benefit Information | 4010X092A1 | 5010X279 | 5010X279A1 |
X12 276 | Health Care Claim Status Request | 4010X093A1 | 5010X212 | |
X12 277 | Health Care Information Status Notification | 4010X093A1 | 5010X212 | |
X12 277 CA | Health Care Claim Acknowledgment | 5010X214 | ||
X12 278 | Health Care Services Review Information Request | 4010X094A1 | 5010X217 | |
X12 820 | Payment Order/Remittance Advice | 4010X061A1 | 5010X218 | 5010X306 |
X12 834 | Benefit Enrollment and Maintenance | 4010X095A1 | 5010X220 | 5010X220A1 |
X12 835 | Health Care Claim Payment/Advice | 4010X091A1 | 5010X221 | 5010X221A1 |
X12 837P | Health Care Claim Professional | 4010X098A1 | 5010X222 | 5010X222A1 |
X12 837I | Health Care Claim Institutional | 4010X096A1 | 5010X223A1 | 5010X223A2 |
X12 837D | Health Care Claim Dental | 4010X097A1 | 5010X224A1 | 5010X224A2 |
X12 999 | Implementation Acknowledgment | 5010X231A1 |
X12 HIPAA parsing and generation examples
- Parse and generate X12 HIPAA 270
- Parse and generate X12 HIPAA 271
- Parse and generate X12 HIPAA 276
- Parse and generate X12 HIPAA 277
- Parse and generate X12 HIPAA 278
- Parse and generate X12 HIPAA 820
- Parse and generate X12 HIPAA 834
- Parse and generate X12 HIPAA 835
- Parse and generate X12 HIPAA 837P
- Parse and generate X12 HIPAA 837I
- Parse and generate X12 HIPAA 837D
- Generate X12 HIPAA 999
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