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Last Modified: 1/13/2017 Location: FL, PR, USVI Business: Part A, Part B

HIPAA 5010 transaction edits: January 2017 update

Due to the Health Insurance Portability and Accountability Act (HIPAA), change request 9666, and electronic data interchange (EDI) front-end updates, the Centers for Medicare & Medicaid Services has implemented 5010 837P and 837I transaction edits, effective January 1, 2017.

Updated 5010 837P transaction edits -- effective January 1, 2017

Edit reference number

Change

X222.351.2400.SV104.045
changed to 999E edit

Updated 5010 837I transaction edits -- effective January 1, 2017

Edit reference number

Change

X223.424.2400.SV205.040
changed to 999E edit
X223.424.2400.SV205.050
revised 277T edit
X223.476.2430.SVD05.065
need to allow for zero value
X223.486.2430.DTP.015
edit is based per payer
X223.486.2430.DTP.020
edit is based per payer

Deactivated 5010 837I transaction edits -- effective January 1, 2017

Edit reference number

Change

X223.476.2430.SVD05.060
edit deactivated
X223.387.2330B.N404.010
deactivate 999E edit
X223.387.2330B.N407.010
deactivate 999E edit

Added 5010 837P transaction edits -- effective January 1, 2017

Edit reference number

Change

X222.351.2400.SV104.043
Change to comply with TR3 2400.SV104 must be 1-8 digits and limited to 0, 1, 2, or 3 decimal positions
X222.351.2400.SV104.047
added 277T single claim flagged for edit
X222.351.2400.SV104.048
added 277T single claim flagged for edit 'MJ'

Added 5010 837I transaction edits -- effective January 1, 2017

Edit reference number

Change

X223.187.2300.HI01-2.025
Added edit ICD-10 E-codes are not valid for Admitting Diagnosis
X223.189.2300.HI01-2.025
Added edit ICD-10 E-codes are not valid for Patient Reason for Visit
X223.189.2300.HI02-2.025
Added edit ICD-10 E-codes are not valid for Patient Reason for Visit
X223.189.2300.HI03-2.025
Added edit ICD-10 E-codes are not valid for Patient Reason for Visit
X223.424.2400.SV205.025
Added new 999R edit unit of service edit change to comply with TR3 2400.SV205 must be 1-8 digits and limited to 0, 1, 2, or 3 decimal positions
X223.193.2300.HI01-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI02-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI03-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI04-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI05-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI06-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI07-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI08-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI09-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI10-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI11-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223.193.2300.HI12-2.055
Added edit ICD-10 E-codes must begin with a "V", "W", "X" or "Y"
X223A2.26.2430.SVD05.025
Added new 999R edit Change to comply with TR3 2400.SVD05 must be 1-8 digits and limited to 0, 1, 2, or 3 decimal positions
Source: CR 9666
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