Implementation of X12 5010
Florida Medicaid implemented the 5010 version of the HIPAA standard transactions on January 1, 2012. If your X12 claims transactions are rejected by the Florida Medicaid system please validate that you are submitting the 5010 version by consulting your clearinghouse or vendor.
HIPAA 5010 versions introduce new formats and additional data elements for transactions and code sets that are required to be implemented by all users of electronic health care transactions. Florida-specific updates are outlined in the 5010 Companion Guides.
For Florida Medicaid, the HIPAA transactions listed below will be impacted by the 5010 transition:
- 837 Institutional Health Care Claim
- 837 Professional Health Care Claim
- 837 Dental Health Care Claim
- 835 Health Care Electronic Remittance
- 270/271 Health Care Eligibility Benefit Inquiry and Response
- 276/277 Health Care Claims Status and Response
- 834 Benefit Enrollment and Maintenance
- 820 Health Care Premium Payments
- 277U Unsolicited Claims Acknowledgement
- 997 Functional Acknowledgement
