MedicaidAdministrativeHigh impact
Announcing HIPAA ASC X12 Version 5010 Companion Guides, NCPDP Version D.0 Payer Sheet, and Testing Information
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Jan 1, 2012
We identified it
Jun 20, 2026
Summary
ForwardHealth (Wisconsin Medicaid) is implementing new HIPAA ASC X12 Version 5010 and NCPDP Version D.0 electronic transaction standards effective January 1, 2012. All electronic claims, eligibility checks, and prescription transactions must use the new formats, with compliance testing required before the deadline.
Action Required
By October 15, 2011: Billing team must download new companion guides from ForwardHealth Portal and update Trading Partner Profile. By December 31, 2011: Complete compliance testing with ForwardHealth for all electronic transactions (837 claims, 270/271 eligibility, 276/277 status requests). Contact billing service/clearinghouse to ensure they support Version 5010 and NCPDP D.0 formats. Update software to use 999 Functional Acknowledgment instead of 997. Failure to upgrade will prevent electronic claim submission after January 1, 2012.