HIPAA-X12N

HIPAA X12N is the set of X12 Transaction Sets (837, 270/271, 835, 834, 820, 276/277, 278) governed by the ASC X12N subcommittee for HIPAA compliance.

Definition

The X12N (Insurance) subcommittee maintains the TR3 (Technical Report Type 3) documents that define HIPAA versions of X12 Transaction Sets. Current versions: 005010X222 (837 Professional), 005010X223 (837 Institutional), 005010X224 (837 Dental), 005010X279 (270/271), 005010X221 (835).

Origin

Subcommittee founded in 1991. The HIPAA TR3s are frozen on 005010 since 2012, except minor technical addenda (errata).

Use

A US health insurer receives daily thousands of 837P (Professional claims) version 005010X222 from medical offices. Strict TR3 X12N compliance is validated by tools like EDIFECS and BlueButton.

Related terms

• HIPAA — regulation.
• TR3 — implementation guides.
• X12 — parent standard.
• X12 837 CLM — TS example.