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DPW HIPAA 5010 Electronic Transactions
October 19, 2010

The Department of Public Welfare (DPW) distributed a letter reminding providers of requirements for use of ANSI X12 version 5010 and NCPDP version D.0 in HIPAA-compliant electronic health care and pharmacy transactions by January 1, 2012. DPW recommends that providers contact vendors, billing services, or clearinghouses as applicable to upgrade software to meet the requirements established in the final rule on transaction standards published in the Federal Register, January 16, 2009 (http://edocket.access.gpo.gov/2009/pdf/E9-740.pdf). DPW has provided information to all certified HIPAA transaction software vendors and clearinghouses regarding requirements for certifying software with PROMISe. Providers are encouraged to discuss this information with vendors and/or clearinghouses. If software is not certified with DPW, health care claims may not be paid.

The DPW letter included a link to obtain copies of the letter, additional information regarding certification requirements, and more information about 5010 and NCPDP D.0. Unfortunately, the link does not currently work as the DPW web site is undergoing improvements. PCPA will continue to work with the department to identify new links to this information as changes to the web site are completed. The DPW letter is available.  Information is also available on the federal web site (http://www.hhs.gov/ocr/privacy/hipaa/administrative/). Contact Betty Simmonds with questions.

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