HIPAA Simplified

Claims / Encounters

The ASC X12N Health Care Claim: Professional (837P), Institutional (837I), and Dental (837D) transactions allow healthcare professional, institutional, and dental providers to submit healthcare claims for a service or encounter.  A healthcare claim includes:

  • Patient Information
  • Related diagnoses
  • Procedures performed or services provide
  • Related charges

Standards

Current Version

The current industry version of the ASC 12N Health Care Claim (837) transactions is 5010 They are:

  • ASC X12N/005010X222A2 Health Care Claim: Professional (837P)
  • ASC X12N/005010X223A3 Health Care Claim: Institutional (837I)
  • ASC X12N/005010X224A3 Health Care Claim: Dental (837D)

These versions were adopted under HIPAA to replace version 4010 on January 16, 2009 and can be purchased at: www.x12.org/products.

  • ASC X12N/005010X222A2 Health Care Claim: Professional (837P)
  • ASC X12N/005010X223A3 Health Care Claim: Institutional (837I)
  • ASC X12N/005010X224A3 Health Care Claim: Dental (837D)

View the Regulation

Next Published Version

See the Change Healthcare Regulatory and Standards Quarterly Update for details concerning the X12 publication schedule.

The next published version of the ASC X12N Health Care Claim (837) transactions will be 7030™. 

Anticipated Regulation

Immediately following publication of 7030TM, X12 will promote the TR3s to version 8010 TM and is expected to recommend the 8010 TM version to CMS for adoption under HIPAA.

Note: Following the publication of version 8010, X12 will move to an annual release cycle of TR3s.  See https://x12.org/about/arc-faq for more information.

7030TM and 8010TM are trademarks of X12.  All rights reserved.