ANSI ASC X12 Glossary

Purpose

The purpose of this document is to highlight some of the terms used in the development and use of the ANSI ASC X12 standards.  All definitions in italics are taken from the WEDI HIPAAA Glossary. 

http://www.wedi.org/public/articles/HIPAA_GLOSSARY.pdf

This glossary is intended to provide a user-friendly way to start to understand the terminology used to develop and maintain ANSI ASC X12 standards used for public health implementations.

Terms of Note

Accredited Standards Committee (ASC)               
An organization that has been accredited by ANSI for the development of American National Standards.

American National Standards Institute (ANSI)       
An organization that accredits various standard-setting committees, and monitors their compliance with the open rule-making process that they must follow to qualify for ANSI accreditation.

Data Maintenance (DM)                                
The name given to change requests to X12 Standards.

Data-Related Concepts

Clinical or Medical Code Sets
Medical conditions and the procedures, services, equipment, and supplies used to deal with them.

Non-clinical or Administrative Code Sets       
Entities and events that facilitate administrative processes.

External Code Set                                  
Date element code lists that are fully specified and maintained by external organizations.  Maintenance of these code lists is the sole responsibility of the external organization.

Internal Code Set                                   
Data element code lists that are fully specified and maintained within the X12 standards.  Note changes to Internal Codes Sets must be approved as part of the normal standards development process.

Composite Data Elements                        
Groups of closely related data elements that can repeat as a group. (i.e. procedure code and associated procedure date are defined in a composite data element)

Simple Data Elements                             
The smallest unit of named information in the ANSI ASC X12 standards

Segments                                            
Groups of related data elements that typically occur together. (i.e. street address, city, state, and zip code)

Loops                                                
The collection of segments that can repeat.

Transaction Set                                     
A collection of loops and segments that support specific business processes.

Designated Standards Maintenance Organizations (DSMO)
The organizations (X12, HL7, NCPDP, NUBC, NUCC, ADA) named in the HIPAA legislation to administer the change process to the named HIPAA transactions.  Note: changes to any loops or segments in the standard that are used in HIPAA implementation guides must be routed through the DSMO process.

DSMO Organizations

DeCC                                                
Dental Content Committee chaired and hosted by the American Dental Association.  This is a data content organization.

NUBC                                               
National Uniform Billing Committee chaired and hosted by the American Hospital Association.  This is a data content organization whose primary responsible for UB-92 institutional claim form and data  specifications.

NUCC                                               
National Uniform Claim Committee chaired and hosted by the American Medical Association.  This is a data content organization whose primary responsible for HCFA-1500 professional claim form and data specifications.

Health Level 7 (HL7)                              
An ANSI-accredited group that defines standards for the cross-platform exchange of information within a health organization. This is a standards development organization (SDO).

National Council for Prescription Drug Programs (NCPDP)
An ANSI-accredited group that maintains a number of standard forms for use by the retail pharmacy industry, some of which are included in the HIPAA mandates. This is a standards development organization (SDO).

X12                                                   
An ANSI-Accredited group that defines EDI standards for many American Industries, including health care insurance. This is a standards development organization (SDO).

Implementation Guide                                    
A document explaining the proper use of a standard for a specific business purpose.  An implementation guide is always a subset of the set of loops, segments, and data elements in any defined standard.

Required Usage                                           
Segments and Data Elements that must be reported in an implementation of a certain standard.

Situational Usage                                         
Segments and Data Elements that may be reported in an implementation of a certain standard depending on the situational statement that is written in the guide.

X12 Versions                                              
A number indicating when the standard was updated with approved changes.  The 4010 Version of the standard was for approved updates as of October 1997.  The 4050 version of the standard was for approved updates as of October 2001.