HIPAA Version 5010

Transaction version 5010 of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 has been approved. It replaces current HIPAA transactions.

The updated version includes structural modifications of the HIPAA EDI transactions with new or modified segments and data values.

Any business process or technology that stores, processes, or utilizes medical/diagnosis/procedure codes is affected on some level.

Implementation Timeline and Key Dates
  • Level 1 Compliance (12/31/2010)
    Covered Entities should have completed all internal readiness activities and be prepared to begin testing/roll out of the new version in a test or production environment by December 31st, 2010.
  • Roll Out/Dual Use (01/01/2011 - 12/31/2011)
    Covered Entities will be preparing to reach full production readiness with all trading partners. Versions 4010A1 and 5010 can be used throughout all of 2011.
  • Level 2 Compliance/ HIPAA 5010 Only (01/01/2012)

We encourage providers to reach out to their trading partners, software vendors and payors to understand individual timelines for compliance.