Online HIPAA 5010/D.0 Resources

HIPAA Transaction Implementation

• X12^® 5010 Implementation Guides (TR3) and non-medical code sets
  See X12^®'s Licensing Program for information on accessing the Implementation Guides
• NCPDP^® D.0 Implementation Standards
• CAQH^® CORE Operating Rules

Centers for Medicare & Medicaid (CMS) - Regulations

• Administrative Simplification under HIPAA
  To reduce paperwork and streamline business processes across the health care system, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and subsequent legislation set national standards for:
  • Electronic transactions
  • Code sets
  • Unique identifiers
  • Operating Rules
• Administrative Simplification Basics Fact Sheets
• ICD-10 Final Rule
• Timeline of Key Regulations
• Standards-Setting and Related Organizations

U.S. Department of Health & Human Services

• HIPAA Home Page
• HIPAA for Professionals – Provides links to HIPAA, HITECH and other Public Laws

Medicaid Related

• New York Department of Health
• Notices of Privacy Practices for Department of Health HIPAA Covered Programs
• Federal Information

Centers for Medicare & Medicaid (CMS) - Other

• CMS Home
• CMS Online Manual System

National Provider Identifier (NPI)

• NPI Registry and Enumeration System
• NPI Information from CMS

External Coding Resources

• HCPCS Release & Code Sets - Quarterly Updates (CMS)
• ICD-10 (CMS)
• Place of Service Codes (CMS)
• American Medical Association^® (AMA) Current Procedural Terminology (CPT^®)
• American Medical Association^® (AMA) Practice Management Store
• National Uniform Billing Committee^™ (NUBC) Code Sets
• National Uniform Claim Committee^™ (NUCC) Code Sets
• American Dental Association^® (AMA) Code on Dental Procedures and Nomenclature
• FDA National Code Directory (NDC)
• NEW YORK MEDICIAD – Pharmacy List of Reimbursable Drugs
• X12^® External Code Sets (CARC, RARC etc.)

Health Insurance Portability and Accountability Act of 1996

• Original HIPAA Regulations August 20, 1996
• Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards January 16, 2009
• Code of Federal Regulations (CFR) Title 45, Subchapter C, Part 160 (Administrative Simplification)
• Code of Federal Regulations (CFR) Title 45, Subchapter C, Part 162(Administrative Simplification)
• Code of Federal Regulations (CFR) Title 45, Subchapter C, Part 164 (Security and Privacy)

American Recovery and Reinvestment Act of 2009 (ARRA)

• American Recovery and Reinvestment Act of 2009

Patient Protection and Affordable Care Act (PPACA)

• Patient Protection and Affordable Care Act 2010