EDI Instructions

HIPAA Compliant Codes All the Health care EDI Transaction set should use only the following HIPAA Compliant Codes Physicians Current Procedure Terminology (CPT) Health Care Financing Administration Common Procedural Coding System (HCPCS) International Classification of Diseases Clinical Mod (ICD-9-CM) Diseases Provider Taxonomy Codes National Drug Code *ICD-10 codes are not allowed prior to effective mandate date of October 1, 2014. Diagnosis...

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Understanding EDI Structure

EDI StructurePrimary Levels are 1. Interchange Envelops2. Functional Group3. Transaction set Data Element A data element is equivalent to a field in a data dictionary. Data elements have a name, a data element number, a brief description, a data type, and a minimum and maximum length. For elements which represent codes, either a list of valid codes is included or a reference is included to a source outside of the X12 standard. Elements are separated...

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What is an EDI ?

EDI X12 (Electronic Data Interchange) is data format based on ASC X12 standards. It is used to exchange specific data between two or more trading partners. Term ‘trading partner’ may represent organization, group of organizations or some other entity. In most cases it is just organization or company. EDI X12 is governed by standards released by ASC X12 (The Accredited Standards Committee). Each release contains set of message types like invoice,...

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