HIPAA EDI component examples

This documentation describes the HIPAA EDI component examples.

ICD-10
The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a set of codes classified by the World Health Organization (WHO) used by physicians, hospitals, and other healthcare organizations to identify patient diagnosis and medical procedures. In the United States, the codes are used by providers and payers for many uses within health care systems, including patient care decision support and claims adjudication.
278N example
The 278N example contains sample mapping with the 278 transaction, "Health Care Services Review Information – Notification". By using sample input data with multiple 278 transactions, the example creates an XML based report for the notifications included in the input.
HIX example
The Health Insurance Exchange (HIX) example demonstrates structures and concepts that surround the HIX processing structures.
Preview Draft 80X0
The ASC X12 Insurance Subcommittee, called X12N, is currently managing a series of public review periods to define new implementation guides for the healthcare insurance industry. These implementation guides will eventually replace the HIPAA-adopted TR3s.
X12N example
This example contains schemas that support X12 standard integrity checking (WEDI SNIP Type 1 Validation) for a set of healthcare industry implementation guides produced by ASC X12's Insurance Subcommittee (X12N). These schemas do not conform to the industry TR3s but to the base X12 standard. They are useful for data transformation purposes; they should not be used for data validation for any WEDI/SNIP level above 1.
External Code List Utilities example
The External Code List Utilities example contains a utility map that loads the code set database with the external code sets that are supported in the pack into a MongoDB NoSQL database.
Type 7 User Exit example
This example contains a Java Program that can be used as a guide to help with the development and requirements of a Java custom user exit for Type 7 validation.
ClaimToExposure tracking example
In the era of COVID-19 many organizations will find it helpful to be able to do a quick scan of the data they already have access to in order to quickly isolate individuals with diagnosis codes of COVID-19 or indicating COVID-19 in order to take quick action.
X12N personal health records example
To support ways for the payer community to leverage existing B2B infrastructure while also beginning to work with HL7 CDA R2 and FHIR (in Json or XML), X12 has a draft implementation guide that describes the use of the AXC X12 Patient Information (275) transaction set for the business purpose of transferring Personal Health Record (PHR) information between different health plans.

Parent topic: HIPAA EDI component