HIPAA is an acronym for the Health Insurance Portability and Accountability Act of 1996. HIPAA protects the privacy rights of patients and the health information held by covered entities. Since the implementation of the first HIPAA regulations, the rules have been frequently updated or changed. The most recent change to HIPAA is called HIPAA ASC X 12 version 5010. There are some major differences between the new and old 4010 versions. HIPAA 5010 includes the ability to support new-use cases, which were brought by industry members; clarification of usage to remove ambiguity; consistency across transactions; support of the NPI regulation, and removal of data content that is no longer used.
It also includes different health plan codes which are necessary and are required for the new transaction set of standards. It is also important to mention, that the use of HIPAA 5010 is mandated by federal law. The upgraded standards, which are listed in the HIPAA 5010, are required for insurance claims made by physicians, hospitals, pharmacies and dentists to insurance companies and health plan clearinghouses. The Centers for Medicare & Medicaid Services (CMS) have moved the deadline for compliance with the new 5010 standards to March 31, 2012. Soon, HIPAA 5010 will accept the new version, which will make it easier to use for medical billing transactions.