Under the final ICD-10 rule, all healthcare providers will utilize ICD-10-CM to code diagnoses beginning October 1, 2013. For procedure coding under the final ICD-10 rule, physicians and all healthcare providers other than inpatient hospitals will continue to use the current procedure coding standard: Current Procedural Terminology, 4th Edition (CPT-4) and the Healthcare Common Procedure Coding System (HCPCS). Inpatient hospital services procedures will be coded using ICD-10-PCS codes, which provide facility related procedure codes suitable to inpatient environments.
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HIPAA Administrative Simplification: Modifications to Medical Data Code Set Standards to Adopt ICD-10-CM and ICD-10-PCS
Standards. The final rule adopts modifications to two code set standards in the Transactions and Code Sets final rule that required compliance by covered entities on or after October 16, 2003. The new final rule, published in the Federal Register on January 16, 2009, modifies standard medical data code sets for coding diagnoses (ICD-10-CM) and inpatient hospital procedures (ICD-10-PCS). ICD-10-CM means International Classification of Diseases, 10th Revision, Clinical Modification for diagnosis coding, including the Official ICD-10-CM Guidelines for Coding and Reporting, as maintained and distributed by the U.S. Department of Health and Human Services (HHS). ICD-10-PCS means International Classification of Diseases, 10th Revision, Procedure Coding System for inpatient hospital procedure…
Categories HIPAA Law, Transactions & Code SetsLeave a commentCompanion Guides
HHS notes that “the improvements to Version 5010 should minimize dependence on companion guides… and “strongly discourage[s] health plans from having companion guides unless they are focused significantly on the basics for continuity, trading partner arrangements, and use of situational data elements…. [I]f companion guides contradict the implementation guides, the transaction will not be compliant.” [74 FR 3307-3308]
Categories 5010Leave a commentDual Use of Existing Standards
Note that HHS permits the dual use of existing standards (4010/4010A1 and 5.1) and the new standards (5010 and D.0) from the March 17, 2009, effective date until the January 1, 2012 compliance date, to facilitate testing and subject to trading partner agreement.
Categories 5010Leave a commentNew HIPAA Standard Transaction Rules Released
On Friday, January 16, 2009, the Office of the Secretary of the Department of Health and Human Services published in the Federal Register final rules pertaining to: Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards (74 Federal Register 3295-3328); and, HIPAA Administrative Simplification: Modifications to Medical Data Code Set Standards to Adopt ICD-10-CM and ICD-10-PCS (74 Federal Register 3328-3362).
Categories 5010, Transactions & Code SetsLeave a comment5010 Testing
HHS recommends that the first of two testing levels of Version 5010 and D.0 begin now for all covered entities to achieve compliance beginning January 1, 2012. HHS expects no contingency period beyond that date and may impose civil penalties for non-compliance.
Categories 5010Leave a commentFinal 5010 Rule
DEPARTMENT OF HEALTH AND HUMAN SERVICES 45 CFR Part 162 | [CMS–0009–F] | RIN 0938–AM50 Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards AGENCY: Office of the Secretary, HHS. ACTION: Final rule. Download (Requires Acrobat Reader)
Categories 5010Leave a commentFinal ICD-10 Rule
DEPARTMENT OF HEALTH AND HUMAN SERVICES 45 CFR Part 162 | [CMS–0013–F] | RIN 0958–AN25 HIPAA Administrative Simplification; Modifications to the Medical Data Code Set Standards to Adopt ICD-10-CM and ICD-10-PCS AGENCY: Office of the Secretary, HHS. ACTION: Final rule. Download (Requires Acrobat Reader)
Categories Transactions & Code SetsLeave a commentNIST Guide for Implementing HIPAA Security Rule
US DEPARTMENT OF COMMERCE National Institute of Standards and Technology NIST Special Publication 800–66 Revision 1 Download (Requires Acrobat Reader)
Categories SecurityLeave a commentPersonal Health Records (PHRs) and the HIPAA Privacy Rule
U.S. Department of Health and Human Services, Office for Civil Rights Download (Requires Acrobat Reader)
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