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To: Sub-Driver

This has been coming for a long, long, time. The question “what about HIPAA?” is wrongheaded. This database IS HIPAA. The same legislation that gave us HIPAA laid the ground work for this.

Working backwards, here’s a referene to an NPR report from June 2004, and a “Question and Answer” about standardized government-mandated “Code Sets” for describing medical conditions and occurrences, from 2000 [Clinton Administration].

From NPR:

July 22, 2004 · The Department of Health and Human Services announces plan to computerize and standardize health records over the next 10 years. The new system, which would make patients’ records available nationwide, is aimed at boosting privacy standards and improving health care efficiency. NPR’s Joanne Silberner reports.

Working further backwards,here’s a website from 2000 with information on “Code Sets”. — Note they were adopted almost a decade ago, “As HIPAA standards” — the “privacy act” makes sure that anyone can encapsulate your medical history in shorthand through the use of mandatory government codes.

http://aspe.hhs.gov/admnsimp/faqcode.htm#codesetsadopted

What code sets have been adopted as HIPAA standards?
The Secretary has adopted the following code sets as the standard medical data code sets:

International Classification of Diseases, 9th Edition, Clinical Modification, (ICD-9-CM), Volumes 1 and 2 (including The Official ICD-9-CM Guidelines for Coding and Reporting), as updated and distributed by HHS, for the following conditions:

Diseases.
Injuries.
Impairments.
Other health related problems and their manifestations.
Causes of injury, disease, impairment, or other health-related problems.
International Classification of Diseases, 9th Edition, Clinical Modification, (ICD-9-CM), Volume 3 Procedures (including The Official ICD-9-CM Guidelines for Coding and Reporting), as updated and distributed by HHS, for the following procedures or other actions taken for diseases, injuries, and impairments on hospital inpatients reported by hospitals:

Prevention.
Diagnosis.
Treatment.
Management.
National Drug Codes (NDC), as updated and distributed by HHS, in collaboration with drug manufacturers, for the following: [Note that Secretary Thompson has indicated in a letter to the NCVHS that HHS will publish an NPRM in the near future proposing to retract the adoption of NDC for all transactions save those for retail pharmacies.]

Drugs.
Biologics.
Code on Dental Procedures and Nomenclature, as updated and distributed by the American Dental Association, for dental services.

The combination of Centers for Medicare & Medicaid Services (formerly known as Health Care Financing Administration) Common Procedure Coding System (HCPCS), as updated and distributed by HHS; and Current Procedural Terminology, Fourth Edition (CPT-4), as updated and distributed by the American Medical Association, for physician services and other health related services. These services include, but are not limited to, the following:

Physician services.
Physical and occupational therapy services.
Radiological procedures.
Clinical laboratory tests.
Other medical diagnostic procedures.
Hearing and vision services.
Transportation services including ambulance.
The Centers for Medicare & Medicaid Services (formerly known as Health Care Financing Administration) Common Procedure Coding System (HCPCS), as updated and distributed by CMS, HHS, for all other substances, equipment, supplies, or other items used in health care services. These items include, but are not limited to, the following:

Medical supplies.
Orthotic and prosthetic devices.
Durable medical equipment.

Can HCPCS Level 3 codes established on a local basis still be used?

No. All local codes will be eliminated. Users that need codes must apply to the appropriate organizations (e.g. CMS for HCPCS codes, the AMA for CPT-4 codes) for national codes.

Where can I get more information about the code sets?
ICD-9-CM: Official version is available on CD-ROM from the Government Printing Office (GPO) at 202-512-1800 or FAX: 202-512-2250. The CD-ROM contains the ICD-9-CM classification and coding guidelines. Versions of ICD-9-CM are also available from several private sector vendors.

CPT-4: Official version is available from the American Medical Association. Versions are also available from several private sector vendors.

HCPCS: Information about HCPCS is available from the CMS by searching their web site at http://cms.hhs.gov.

Code on Dental Procedures and Nomenclature: Official version is available from the American Dental Association at 800-947-4746.

NDC: Official versions of the files are available on the Internet at http://www.fda.gov/cder/ndc/index.htm. NDC codes are also published in the Physicians’ Desk Reference under the individual drug product listings and “How supplied.” The supplements are available quarterly on diskette from the National Technical Information Service at 703-487-6430.


43 posted on 02/12/2009 12:50:02 PM PST by Flash Bazbeaux
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To: Flash Bazbeaux

With all the new controls and regulations, their will be an explosion in the need for coders. Unemployed people might want to consider getting training here.


68 posted on 02/12/2009 2:53:10 PM PST by mollynme (cogito, ergo freepum)
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