HIPAA 5010 Support RTM for BTS 2009

Support for HIPAA 5010 on top of BizTalk Server 2009 is now ready for download. As part of this feature BizTalk 2009 brings in the following functionality

– Ability to handle HIPAA version 5010 and 4010A messages. Following replacement schemas have been added for 5010 as part of this support

1) 270: Health Care Eligibility/Benefit Inquiry

2) 271: Health Care Eligibility/Benefit Information Response

3) 276: Health Care Claim Status Request

4) 277: Health Care Claim Status Response

5,6) 278: Health Care Services Request for Review and 278: Health Care Services Response to Request for Review (Both included in the same schema)

7) 820: Payroll Deducted and Other Group Premium Payment for Insurance Products

8) 834: Benefit Enrollment and Maintenance

9) 835: Health Care Claim Payment/Advice

10) 837: Health Care Claim: Professional

11) 837: Health Care Claim: Institutional

12) 837: Health Care Claim: Dental


– Support ICD 10 code set along with ICD 9 code sets

– Ability to handle ST03 to determine the version of the transaction set taking precedence over GS08

– Support routing of message over ST03 (i.e., you can use ST03 in the Orchestration and Send port filters)

– Ability to support ‘similar’ transaction sets within a group. The transaction set to group mapping provided by X12 standards is used to determine the set of transaction sets that are similar and can be combined within a single GS-GE.

Here is the link to the hotfix that enables this support http://support.microsoft.com/kb/973415. The release notes and KB article provide details on the functionality available through this feature.

With this release BizTalk reaffirms its commitment to existing Healthcare customers and support to the healthcare market.








Comments (9)

  1. EdiBlog says:

    There is a question about 278: HealthCare Servcies Review Notification and Acknowledgement.

    The 278 schema(s) published and supported in this feature are the mandated set. They are to be used for aspects like "Health care admission certificate requests and responses", "Referral requests and responses", "Health care services certification requests and responses" etc.

    The 278 requested is for Patient arrival notice, Patient discharge notice, Patient transfer notice  etc.

    The current shipped schemas and support is limited to repalcement schemas that are mandated by the federal regulation. The other schemas in the ‘published’ list of 5010 schemas are not intended to be part of this support.

  2. Jayson says:

    EdiBlog, on your last paragraph, does it mean Hipaa schema for 278 Transaction version 005010X216 will be depricated in Hipaa 5010 version?


  3. Ravi Bollapragada says:

    No it just means that it is not part of the 'mandatory' schema set that HIPAA regulation forces – just HIPAA 5040 or 5050 is also a valid version but its not mandated by governing body. The message type is still part of HIPAA 5010 and is used by Healthcare industry. Its just that BizTalk 5010 suppoty doesnt have it out of the box

  4. Jayson says:

    Does it become issue to one who has been developed 278N on 4010 on older BizTalk Server version and now they want to upgrade to 2009 or 2010, which not supported by it?  What MS need to say about this?


  5. Ravi Bollapragada says:


    If customer has developed a 278N for 4010 – and it was working on BTS 2009 – they wont have any issue with it in BTS 2010

  6. Jayson says:


    278 N is 278 Service Review Notification and it is NOT in HIPAA 5010 version of BizTalk 2009 nor 2010 Beta (claimed it by MS).  278 Request and Response do support in HIPAA 5010 with BizTalk 2009/2010.  I don't know where you get the information of 278N is working on BTS 2009 – HIPAA 5010???


  7. Ravi Bollapragada says:


    I am not saying Microsoft BizTalk Server 2009 or 2010 ship this 278 N schema. I am referring to your statment "Does it become issue to one who has been developed 278N on 4010 on older BizTalk Server version ", to state that if someone developed it in BTS 2009/2006 R2 on 4010 – it will continue to work

  8. Chris says:

    Now that Hippa just released 5010a1 (a2) Errata do we need another Hotfix???

    We were just about to apply this hotfix when the Errata just came out.



  9. Anthony says:

    Has anyone heard anything about BizTalk 2009/2010 support 5010<b>A</b> yet?