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HHS releases proposed claims attachment rule

Ambulatory Surgery Reimbursement Update, September 27, 2005

The United States Department of Health and Human Services (HHS) has published a proposed rule for electronic claims attachments-documents and information required by health plans to adjudicate certain claims.

The proposed rule, mandated by HIPAA, adopts two new X12 transaction standards, an HL7 messaging standard to carry clinical information in the response transaction, and HL7 specifications for the content or "questions" that may be asked in each of the six attachment types.

The claims attachment rule also adopts the Logical Observation Identifiers Names and Codes (LOINC®) as a new HIPAA code set to be used to identify the questions and answers. The standards allow for the transmission of structured or coded data, as well as images and text. The public comment period is open until November 22.

The proposed rule can be found in the September 23 Federal Register by clicking here.

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