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ANSI ASC X12 Change Process 101

Overview of X12 Organization

ANSI ASC X12 standards are developed using a consensus process. To understand the X12 change process it is necessary to understand the X12 organization. Below is an X12 organization chart. It should be noted that not all subcommittees, task groups, or work groups are listed, but all the relevant groups necessary to make a change to the Claim/Encounter 837 standard are included. Changes to the ANSI ASC X12 standards are called data maintenance (DM).

X12 Organization Chart

X12 Change Process Summary for recommended changes to X12 standard
 
Step 1 Work Group Approval: Change request (DM) presented to work group for discussion and approval. If this is a change to the claim / encounter 837-transaction set, the claims work group (X12N TG2 WG2) would be the approving group. If this is a change to the standard, any other work groups that are developing transaction sets that would also use the part of the standard to be changed must also grant approval. This step involves creating a business case for the proposed change and presenting it before the work group at one of the ANSI ASC X12N trimester meetings.
 
Step 1A Architecture Approval: This step is optional, but it is highly recommended. Architecture (X12N TG8) is staffed by experts in the X12 standard. Their review typically ensures that X12 syntax rules are followed with each request to change X12 standards. This step involves creating a business case for the proposed change and presenting it before the task group at one of the ANSI ASC X12N trimester meetings.
 
Step 2 Task Group Approval: Change request (DM) is presented to the Health Care Task Group (X12N TG2) for discussion and approval. If the change to the standard affects other task groups it is highly recommended that those affected task groups be consulted before the change request is moved to step 4. This step involves creating a business case for the proposed change and presenting it before the task group at one of the ANSI ASC X12N trimester meetings.
 
Step 3 Subcommittee Approval: Change request (DM) is presented to the Insurance Subcommittee (X12N) for discussion and approval. If the change to the standard affects other subcommittees it is highly recommended that those affected subcommittees be consulted before the change request is moved to step 4. This step involves creating a business case for the proposed change and presenting it before the N subcommittee at one of the ANSI ASC X12N trimester meetings.
 
Step 4 Technical Assessment Approval:Change request (DM) is presented to the Technical Assessment Subcommittee (X12J) for approval.
 
Step 5 X12 Ballot Approval: Change request is put on a ballot to be approved by the general X12 membership. A vote to disapprove must be accompanied by a reason and signed by the dissenting individual or organization.
 
Notes: If there is a vote to disapprove at any step in the process the individual or group suggesting a change would need to go back one step to resolve the issues that caused the negative votes.

If a data maintenance request involves changes to a transaction named in the HIPAA legislation, the change must be approved by the Designated Standards Maintenance Organizations (DSMO).

 

X12 Change Process Summary for recommended changes to X12N Implementation Guide
 
Step 1 Work Group Approval:Change request presented to work group for discussion and approval. This step involves creating a business case for the proposed change and presenting it before the work group at one of the ANSI ASC X12N trimester meetings.
 
Step 2 Task Group Approval: Change request is presented to the Health Care Task Group (X12N TG2) for discussion and approval. This step involves creating a business case for the proposed change and presenting it before the task group at one of the ANSI ASC X12N trimester meetings.
 
Step 3 Subcommittee Approval:Change request is presented to the Insurance Subcommittee (X12N) for discussion and approval. This step involves creating a business case for the proposed change and presenting it before the N subcommittee at one of the ANSI ASC X12N trimester meetings.
 
Notes: If there is a vote to disapprove at any step in the process the individual or group suggesting a change would need to go back one step to resolve the issues that caused the negative votes.

 

Web Site References
 
Standing Document 2: Operations Manual: Development and Maintenance Procedures for Standards, Interpretations, Guidelines and Technical Reports. This is an ANSI ASC X12 document that defines the procedures that must be followed for development and maintenance of ANSI ASC X12 standards.

http://www.x12.org/x12org/Subcommittees/dev/sd2.pdf
 

X12 Workbook The ANSI ASC X12 standards can be downloaded from this web site. You or your organization must be a member of ANSI to be able to download the standards, which include all the X12 transactions, segments, data elements, data maintenance, and code lists. Go to the website, the X12 home page, and click on the Drop Down Box with Quick Links as first entry in upper right hand corner.

http://www.x12.org
 

Implementation Guides The X12 implementation guides are published by the Washington Publishing Company. The implementation guides are available through the Washington Publishing Company Wed site.

http://www.wpc-edi.com
 

DSMO Web Site This web site is the entry point for changes to the ANSI ASC X12 transactions named in the HIPAA legislation. All changes to the mandated HIPAA transactions must be approved by the Designated Standards Maintenance Organizations. Requests are initiated and tracked via this web site. Note: To enter a change request, you will need to go through a registration process.

http://www.hipaa-dsmo.org/
 

NCHS position statement See document that describes the National Center for Health Statistics (NCHS) position on Race/Ethnicity, 2009