How to find HIPAA transaction code sets and HITECH resources

How to find HIPAA transaction code sets and HITECH resources

Do you have a recommendation for a good HITECH and/or HIPAA security audit resource(s)? I am particularly interested in code sets, transaction codes and HIPAA assessments.

    Requires Free Membership to View

    Login

    SearchSecurity.com members gain immediate and unlimited access to breaking industry news, virus alerts, new hacker threats, highly focused security newsletters, and more -- all at no cost. Join me on SearchSecurity.com today!

    Michael S. Mimoso, Editorial Director

    By submitting your registration information to SearchSecurity.com you agree to receive email communications from TechTarget and TechTarget partners. We encourage you to read our Privacy Policy which contains important disclosures about how we collect and use your registration and other information. If you reside outside of the United States, by submitting this registration information you consent to having your personal data transferred to and processed in the United States. Your use of SearchSecurity.com is governed by our Terms of Use. You may contact us at webmaster@TechTarget.com.

There are a ton of great resources out there concerning transaction codes and code sets. The best resources come directly from the Department of Health and Human Services (HHS). For transactions, HHS also provides a great definition of what transactions are:

"Transactions are electronics exchanges involving the transfer of health care information between two parties for specific purposes, such as a health care provider submitting medical claims to a health plan for payment."

HIPAA mandates that, if covered entities engage in electronic transactions (and really, how many don't?), they must adhere to certain standards that HHS outlines.

Related to transactions are code sets. According to HHS, code sets are:

"Under HIPAA, a "code set" is any set of codes used for encoding data elements, such as tables of terms, medical concepts, medical diagnosis codes, or medical procedure codes. Medical data code sets used in the health care industry include coding systems for diseases, impairments, other health-related problems, and their manifestations; causes of injury, disease, impairment, or other health-related problems; actions taken to prevent, diagnose, treat, or manage diseases, injuries, and impairments; and any substances, equipment, supplies, or other items used to perform these actions."

HHS provides resources on code sets in their FAQ.

In addition to the HHS resources, there are two other great sites you should check out. The first, provided by the American Medical Association (AMA), covers HIPAA in general and has a specific section on Transactions and Code Sets.

Finally the American Academy of Family Physicians has a great article that covers HIPAA, including some great high-level advice on dealing with the regulation, as well as how to transition an organization to HIPAA compliance.

As for HIPAA assessments, there are several good resources also provided by HHS. One resource gives extensive information on safeguards, policies and risk management. Another resource has a great high-level outline of what to expect as part of being audited (.PDF). Finally, HIPAA auditors, as a general rule, use the Medicaid guidelines (.PDF) provided by the Office of the Inspector General of Health and Human Services.

For more information:

  • Check out these key elements of a HIPAA compliance checklist.
  • Also learn more about creating a HIPAA compliance employee training program.

    • This was first published in August 2009

    Back to top