HL7 CDA R2 AIS Implementation Guide

HL7 Additional Information Specification Implementation GuideCDAR2AIS0000R0301 IntroductionIn conjunction with the documents listed below, this Implementation Guide constitutes a solutionto send additional supporting documentation for various business functions. This includes therequirements for electronic transmission of claims attachments included in the Health InsurancePortability and Accountability Act of 1996 (HIPAA). The specific relationship of this material tothe HIPAA Claims Attachments regulation is further explained in section 1.1.1.Editor's note:This document is currently undergoing edits in reaction to the comments receivedduring the May 2007 ballot and subsequent reconciliation discussions. The editorhas inserted various notes to himself – these are highlighted in yellow background– and you should ignore them. –mikeThe electronic attachment solution is comprised of these basic concepts:• Solicited Attachments - A query/response framework, allowing a provider to respond to apayer’s request for additional information.• Unsolicited Attachments – A framework allowing providers to send additionalinformation unsolicited by the health plan. The provider may send this information in thesame interchange as the claim or in a separate interchange. For HIPAA claimsattachments, the Final Rule published in the Federal Register is expected to define underwhat circumstances unsolicited attachments may be sent.• Standardized codes that represent the specific information needed (or returned), and thatcan limit (or extend) the request to a particular timeframe - see the AIS and LogicalObservation Identifier Names and Codes (LOINC®) Modifiers documents, below.• Adaptability to technological differences among trading partners, to help reduceimplementation barriers - see the rest of this Implementation Guide, and the CDARelease 2.0 Standard, below.The set of specifications that define the attachments standards proposed under the HIPAAregulation are:• Health Level Seven (HL7) Additional Information Specification Implementation Guide,Release 3.0 (this document).• Five HL7 additional information specifications (AIS) containing the LOINC code tablesspecific to requests for additional information. These specifications may be read in anyorder.• The HL7 publication: Additional Information Specification 0999: LOINC ® ModifierCodes (For use with ASC X12 277 and ASC X12 278 Implementation Guides whenRequesting Additional Information).Copyright © 1998-2007 Health Level Seven, Inc. All rights reserved.Release 3.0 Draft StandardPage 1March 2007