Installation Steps

Prerequisites

  • HIPAA/X12N license (8.8.10 and later)
  • Clinical Edits Module license
  • SpecBuilder 8.0 and later
  • XEngine 8.0 and later
  • JDK 11.0.2 or later for 9.2-compatible installation

Install HIPAA Database:

  1. Run the installer Edifecs Standards Database EDI - HIPAA.msi. To get the installer, contact Edifecs support.
  2. Follow the steps of the wizard to complete the installation.

Note HIPAA Database and X12N Database must be set up/installed in the same destination folder to avoid issues with the validation settings installation.

Install HIPAA Crosswalks:

  1. Run the installer Edifecs HIPAACrosswalks.msi. To get the installer, contact Edifecs support.
  2. Follow the steps of the wizard to complete the installation.

After you complete the installation, you get the following crosswalk tables for edits in HIPAA guidelines:

  • HCPCS-ICD10CM: checks for dependencies between the HCPCS Procedure code and ICD-10-CM Diagnosis code(s)
  • HCPCS-Modifier: checks to see whether or not the HCPCS Procedure code is covered and checks for dependencies between the HCPCS Procedure code and HCPCS Modifier code(s)
  • HCPCS-POS: checks for dependencies between the HCPCS Procedure code and the Place of Service (837 Professional) or the Type of Bill (837 Institutional) code
  • HCPCS-Patient: checks for dependencies between the HCPCS Procedure code and patient demographics such as age and gender
  • HCPCSModifier-Coverage: checks to see whether or not the HCPCS Modifier code is covered
  • ICD10CM-Patient: checks for dependencies between the ICD-10-CM Diagnosis code and patient demographics such as age and gender
  • Revenue-HCPCS:checks for dependencies between a Revenue code and the HCPCS Procedure and Modifier code(s).

Note For SpecBuilder/XEngine 9.1 and earlier, crosswalks samples are provided as unregistered and are not used in HIPAA guidelines. You must register your crosswalks to view them. You can use Edifecs SpecBuilder to register crosswalks.

Note If you use SpecBuilder/XEngine 9.1 or earlier, before you update Clinical Edits Module for XEServer, make copies of the crosswalk files you modified since your changes will be overwritten during the product update.