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NCPDPNational Council for Prescription Drug Programs
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By 1 January 2012, covered entities which include health plans, healthcare clearinghouses and certain healthcare providers, must upgrade to HIPAA X12 version 5010 and NCPDP version D.0 in order to further simplify procedures, enhance the uniformity of transactions, streamline reimbursements and combat fraud and abuse.
Compliance with the new HIPAA 5010 and NCPDP D.0 standards is required by 12 January 2012.
Mirth delivers robust HL7, XML, X12, NCPDP, DiCOM interface capabilities in an open source package, providing an alternative to costly proprietary and in-house systems.
* Bidirectional HL7 to XML and NCPDP scripts to enrich support for ESB and SOA healthcare implementations, simplify validation and transformations
* NCPDP Telecommunication Standard, Version 5.1, and supporting NCPDP Batch Standard, Version 1.1, for eligibility queries between dispensers and Part D sponsors.
Along with X12 837, the NPRM proposed adopting ICD-9 codes for institutional-based procedures, CPT-4 and HCFA Common Procedure Coding System (HCPCS) codes for non-institutional or ambulatory department procedures, and National Council for Prescription Drug Programs (NCPDP) codes for drug payment claims.
For example, in the 1990s, NCPDP's membership began working on e-prescribing to address the patient safety and business issues brought on by handwritten prescriptions.
Essentially, to the extent possible, we leverage already established healthcare standards and optimize the use of those standards--like HIPAA, HL7, NCPDP, FHIR (as well as other medical and non-medical code sets).
Many of the proposed administrative standards are commonly used, such as code sets (e.g., ICD-9 CM and CPT-4) and transaction standards (e.g., X12 with payers and NCPDP with pharmacies).