Health Information Management

CMS helps covered entities understand new HIPAA edit requirements

HIPAA Weekly Advisor, May 17, 2004

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Come July 1, your claims will be held to different requirements as specified by HIPAA. In an effort to head off confusion, the Centers for Medicare & Medicaid Services released an educational report about the changes required for your claims to be HIPAA compliant. 

The report discusses the following new expectations in greater detail:

- Medicare claims must include certain HIPAA-required data elements that were not previously conditions of Medicare claims adjudication
- Claims including data prohibited by HIPAA will be rejected
- Claim content formerly edited only for syntax will be examined for content now and could result in claim rejections

Click here http://www.cms.hhs.gov/medlearn/matters/mmarticles/2004/MM3031.pdf to view the entire report.



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