Free HIPAA X12 Compliance Tools & Resources

You now have less than one year to achieve full compliance with HIPAA X12!
The January 1, 2012 compliance date requires the replacement of HIPAA ASC X12 version 4010A1 with version 5010 and NCPDP version 5.1 with version D.0.

Update: CMS has extended a HIPAA 5010 grace period through June 30, 2012. More >>

Did you know?

CMS has already begun accepting the 5010 format. HHS permits the dual use of existing standards (4010A1 and 5.1) and the new standards (5010 and D.0) from the March 17, 2009, effective date until the January 1, 2012 compliance date to facilitate testing subject to trading partner agreement.

CMS’ Compliance Level Deadlines for 5010 and D.0

DeadlineCompliance Level
December 31, 2010Level I Compliance: “a covered entity can demonstrably create and receive compliant transactions, resulting from the compliance of all design/build activities and internal testing”
December 31, 2011Level II Compliance: “a covered entity has completed end-to-end testing with each of its trading partners, and is able to operate in production mode with the new versions of the standards.”
January 1, 2012All covered entities must be fully compliant.


Free Tools and Resources

HCIM recommends using the following timeline and resources to facilitate a successful and timely transition to 5010 and D.0:

HIPAA X12 Modifications Timeline

Plan out the implementation and track your progress with NCHICA and WEDI’s ICD-10 and HIPAA X12 benchmarks.

CMS 5010 EDI Resources

Simplify the 5010/D.0 requirements

Whether you’ve already begun working on the HIPAA EDI changes or still don’t know where to start, HCIM is your resource for guidance and support. For your next steps or for more information, contact HCIM Client Services at or 888-454-0202, ext. 3.

About HCIM

Since 2000, HealthCare Information Management, Inc. (HCIM) has delivered expert consulting services and robotic automation tools for small to mid-sized healthcare payer and managed care organizations. Our concierge consulting services include everything from core claims system procurement to go live, including configuration, migration, upgrades, reporting, benefits and fee schedules, user training, and project resourcing. We also offer strategic consulting in the areas of value based payments, population health, medical management, medical loss analysis and recovery, care management, provider contract modeling, data analytics, and business process reengineering/analysis.