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5010/D.0 Compliance (X12/NCPDP Submitters)

Refer to these resources for Minnesota Health Care Programs (MHCP) claim submissions for 5010 X12 and National Council for Prescription Drug Programs (NCPDP) D.0 transactions.

All health care organizations (payers, providers and vendors) must use 5010/D.0 systems for health care claims and related transactions to comply with federal HIPAA requirements.

  • 5010: Refers to X12 standards for HIPAA batch and direct data entry (DDE) transactions (including claims for supplies and services)
  • D.0: Refers to NCPDP standards for pharmacy retail drug claims (Point of sale D.0 and batch 1.2)

MHCP follows Minnesota Administrative Uniformity Committee (AUC) guidelines to comply with requirements for fee-for-service transactions.

Refer to the appropriate Minnesota Uniform Companion Guides for MHCP transaction guidelines.

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