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TIBCO BusinessConnect™ Container Edition - EDI Protocol HIPAA Edition powered by Instream® 1.0.0

# HIPAA Transaction Guidelines

All the HIPAA guidelines provided with BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream are located as follows:

- `BCCE-<version>_Home/images/services/cms/bcce-cms/config` and `BCCE-<version>_Home/images/services/is/bcce-is/config`

- Fsrest mount path

- `bcce-edihipaa-1.0.0_InstallerFolder/samples/sampleDocs/guidelines`

Example: Version 5010 guidelines are in the directory: `bcce-edihipaa-1.0.0_InstallerFolder/samples/sampleDocs/datafiles/5010_txns`

The following table lists the HIPAA transactions and their associated guidelines:

HIPAA Transactions Guidelines

HIPAA Transaction | HIPAA Guideline
00307/003070X070A1/277 | PDSA3070277UX070A1.std
00401/004010X092A1/270 | PDSA270-B.std (batch)
00401/004010X092A1/270R | PDSA270-RT.std (real-time)
00401/004010X092A1/271 | PDSA271.std
00401/004010X093A1/276 | PDSA276-B.std (batch)
00401/004010X093A1/276R | PDSA276-RT.std (real-time)
00401/004010X093A1/277 | PDSA277.std
00401/004010X094A1/278 (RQ) | PDA278RQ.std
00401/004010X094A1/278 (RSP) | PDA278RP.std
00401/004010X061A1/820 | PDSA820.std
00401/004010X095A1/834 | PDSA834.std
00401/004010X096A1/837 (I) | PDSA837I.std
00401/004010X097A1/837 (D) | PDSA837D.std
00401/004010X098A1/837 (P) | PDSA837P.std
00404/004040X167/277 | PDSA4040277UX167.std
00405/004050X150/277 | PDSA4050277X150.std
00405/004050X151/275 | PDSA4050275X151.std
00405/004050X166/824 | PDSA4050824X166.std
00501/005010X279A1/270 | PDSA5010270X279-B.std (batch)
00501/005010X279A1/270R | PDSA5010270X279-RT.std (real-time)
00501/005010X279A1/271 | PDSA5010271X279.std
00501/005010X212/276 | PDSA5010276X212-B.std (batch)
00501/005010X212/276R | PDSA5010276X212-RT.std (real-time)
00501/005010X212/277 | PDSA5010277X212.std
00501/005010X217/278 (RQ) | PDSA5010278X217Q.std
00501/005010X217/278 (RSP) | PDSA5010278X217R.std
00501/005010X218/820 | PDSA5010820.std
00501/005010X220A1/834 | PDSA5010834.std
00501/005010X221A1/835 | PDSA5010835.std
00501/005010X222A1/837 (P) | PDSA5010837P.std
00501/005010X223A2/837 (I) | PDSA5010837I.std
00501/005010X224A2/837 (D) | PDSA5010837D.std
00501/005010X214/277 | PDSA5010277CAX214.std
00501/005010X186A1/824 | PDSA5010824X186.std
00501/005010X210/275 | PDSA5010275X210.std
00501/005010X213/277 | PDSA5010277X213.std

Guidelines that are designated as real-time transactions have limits applied as follows:

270 Transaction - number of patients limited to 1

276 Transaction - number of claims limited to 1

Guidelines that are designated as batch transactions have limits applied as follows:

270 Transaction - number of patients limited to 99

276 Transaction - number of claims limited to 99

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TIBCO BusinessConnect™ Container Edition - EDI Protocol HIPAA Edition powered by Instream®

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