Guidance: Where to Focus ICD-10 Testing of HIPAA Transactions

New guidance from two industry organizations explains where to focus ICD-10 testing of HIPAA transactions to ensure codes are correctly placed and formatted within the transactions.


New guidance from two industry organizations explains where to focus ICD-10 testing of HIPAA transactions to ensure codes are correctly placed and formatted within the transactions.

The Workgroup for Electronic Data Interchange and the ANSI ASC X12 subcommittee that creates and updates the transaction sets developed the guidance. While it can be argued that implementation of the HIPAA 5010 transactions tested the format to carry ICD-10 codes, “the industry did not focus on assuring that ICD-10 codes were correctly assigned and reflected on these transactions, or that ICD-10 codes were correctly processed in front-end applications,” says Jim Daily, WEDI chair. Consequently, the guidance highlights the transactions and content that will need validation.

The guidance, available here, also can aid to inform an ICD-10 impact assessment and remediation planning. WEDI also continues to solicit additional stakeholders to serve in various workgroups of the organization. For information, send an email to Sam Holvey at sholvey@wedi.org.

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