Transactions and Code Sets

On August 17, 2000, the HIPAA Transactions and Code Set (TCS) regulation was published in the Federal Register. Entitled "Health Insurance Reform: Standards for Electronic Transactions; Announcement of Designated Standard Maintenance Organizations; Final Rule and Notice", this rule implemented some of the requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996.

While the year 2000 regulation pertained to standardizing and requiring electronic billing transfer of information, such as claims, referrals, eligibility requests, remittance advice, etc..as well as the utilization of particular code sets used in those transactions, the 2004 National Provider Identifier regulation pertained to standardizing provider identifiers, and the 2005 proposed Claims Attachment regulation pertains to standardizing and automating the process of attaching additional claim information to the electronic claim. The government also wanted to give us tools to enforce these requirements, and thus the 2003 rule gave us the proposed Enforcement regulation.

HIPAA Transactions and Code Sets (TCS) include:

Claims Attachments

Code Sets