HIPAA Administrative Simplification (Transactions and Code Sets)

1. Administrative simplification overview

   Standard electronic transactions, code sets and identifiers.

2. 45 CFR Part 162

   Adopted standards for claims, eligibility, remittance and other transactions.

3. Version 5010

   X12 5010 and NCPDP D.0 adoption.

4. Code sets

   ICD-10, CPT, HCPCS, CDT and NDC adopted as standard code sets.

5. Identifiers

   NPI as the standard provider identifier.

6. Operating rules

   CAQH CORE operating rules for eligibility, claim status and EFT/ERA.

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