HIPAA 5010 Transactions Standards & Code Sets (HIPAA 5010) readiness statement

On January 16, 2009, the U.S. Department of Health and Human Services (HHS) released the final rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regarding updated standards for electronic healthcare transactions: X12 Version HIPAA 5010.

MagnaCare Readiness

MagnaCare is committed to delivering excellent service and has adopted HIPAA transactions and code sets, including compliance with and support of HIPAA 5010.

Submit Your HIPAA 5010 Questions

Please note the replacement of the original base versions by the Errata in the chart below. Transactions not supported by MagnaCare are shown as “Not applicable.”

Transactions Affected by the Errata Errata Version
Compliance
January 1, 2012
Base Version
Compliance
January 1, 2012

820 Premium Payment

005010X218

Not Applicable

834 Benefit Enrollment and Maintenance

005010X220

005010X220A1

835 Health Care Claim Payment/Advice

005010X221

005010X221A1

837 Health Care Claim: Professional

005010X222

005010X222A1

837 Health Care Claim: Institutional

005010X223

005010X223A2

837 Health Care Claim: Dental

005010X224

Not Applicable

270/271 Health Care Eligibility Benefit Inquiry and Response

005010X279

Payor ID: MAGNA
Realtime service through Change HealthCare

276/277 Claim Status Inquiry/Response

005010X212

Payor ID: MAGNA
Realtime service through Change HealthCare

278 Health Care Claim Services Requests for Review and Response

005010X217

Not Applicable

999 Implementation Acknowledgement For Health Care Insurance

005010X231

005010X231A1

The final rule adopts X12 Version 5010 Errata for HIPAA transactions.

Modifications were introduced as a result of the current 4010A1 electronic transaction standards being outdated and including rules that no longer align with business practices in the healthcare industry.

The HIPAA 5010 final rule applies to all HIPAA covered entities, including health plans, healthcare clearinghouses, and certain healthcare providers. Version 5010 is designed to bring a more consistent use of healthcare transactions to the industry, ultimately making it easier for healthcare providers to submit the same information to all insurance carriers.

5010 Readiness FAQ