WEDI and ASC X12 Provide Key HIPAA Transaction Guidance for ICD-10 Codes

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WEDI and ASC X12 provide key HIPAA transaction guidance for ICD-10 Codes.

The Workgroup for Electronic Data Interchange (WEDI), the leading authority on the use of Health IT to improve the exchange of healthcare information, announced the release of a new ICD-10 issue brief co-written with ASC X12 entitled, ICD-10 Impact to HIPAA Transactions. The issue brief was developed to help the healthcare industry better understand where to focus transaction testing to ensure that codes are correctly placed and formatted within the transactions.

The implementation of ICD-10 impacts virtually every business process and system in health plans, provider facilities, clearinghouses and vendor offerings. WEDI and ASC X12’s issue brief states that, as part of the ICD-10 testing process, it is imperative to assure that ICD-10-CM and ICD-10-PCS codes are accurately passed from providers through to payers within the transactions required under HIPAA to exchange diagnosis and procedure information. The issue brief provides information on the transactions that are impacted by ICD-10 as well as the placement of the codes within the transactions. Knowing where all of the touch points are will help facilitate implementation and testing of ICD-10-CM and ICD-10-PCS.

“Although it can be argued that implementation of version 5010 of the ASC X12 transactions tested the format that will be used to carry ICD-10 codes, the industry did not focus on assuring that ICD-10 codes were correctly assigned and reflected on these transactions or that ICD-10 codes were correctly processed in front end applications,” said Jim Daley, WEDI Chairman. “This document will help highlight the transactions and content that will need to be validated as part of the ICD-10 testing effort. WEDI wishes to thank the many contributions of ASC X12 in creating this issue brief.”

The ICD-10 Impact to HIPAA Transactions issue brief was written by WEDI’s ICD-10 Workgroup and ASC X12 staff members and is available for download on the WEDI website. WEDI invites individuals who want to be involved in the development of similar industry resources in the future to join a WEDI workgroup or contact Sam Holvey at sholvey(at)wedi.org.

About WEDI
The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of Health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency and to reduce costs of our nation’s healthcare system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations and standards bodies.

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