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Transaction and Code Sets Standards

Transactions and Code Sets Regulations

Modifications Rule to Electronic Data Transaction Standards and Code Sets

The Final Rule adopting changes to the HIPAA Electronic Transactions and Code Set Standards was published in the Federal Register on February 20, 2003.  This final rule modifies a number of the electronic transactions and code sets adopted as national standards under HIPAA, and eliminates the National Drug Code (NCD) code set as the standard for all providers except retail pharmacies.  To view, see the link in the Downloads section below.

Standards For Electronic Transactions-Final Rule

The final rule adopting standards for eight electronic transactions and for code sets to be used in those transactions was published in the Federal Register on August 17, 2000.  The use of these standard transactions and code sets will improve the Medicare and Medicaid programs, other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the system and enabling the efficient electronic transmission of certain health information. To view, see the link in the Downloads section below.

Standards For Electronic Transactions-Proposed Rule

The proposed rule for HIPAA Electronic Transactions was published in the Federal Register on May 7, 1998. This rule proposed standards for eight electronic transactions and for code sets to be used in those transactions. It also proposed requirements concerning the use of these standards by health plans, health care clearinghouses, and health care providers.  To view, see the link in the Downloads section below.

Standards For Electronic Transactions-Corrections

Technical corrections to the final rule were published in the Federal Register on November 24, 2000. To view, see the link in the Downloads section below.

Designated Standards Maintenance Organizations (DSMO)

The Designated Standards Maintenance Organizations were announced in the Federal Register on August 17, 2000. To view, see the link in the Downloads section below.

Downloads


Modifications to Electronic Data Transaction Standards and Code Sets [PDF, 367KB]

Standards For Electronic transactions-Final Rule [PDF,472 KB]

Standards For Electronic Transactions-Proposed Rule [PDF, 324KB]

Standards For Electronic Transactions-Corrections [PDF, 117KB]

DSMO [PDF, 115KB]
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