Martin,
There are NO optional use segments, elements or codes in HIPAA. Here's the
way to read the HIPAA IGs:
Not used. Do NOT use this element.
Situational. Read the BOLD print to determine in which situations the
segment, element or code becomes either required or not used.
Required. You MUST use this element.
Additionally, since in the X12 standards (on which the HIPAA standards are
based) there are some elements that have conditional relationships to other
elements, these conditional relationships must be complied with. Thus, if an
element is situational, read the bold print very carefully to determine
whether or not the situation applies in your case and then if it does, and
the element also has a conditional relationship with another, you must also
use that other element. Most often, the conditionality is between an element
containing coded data and a qualifier which gives meaning to the coded data.
Don't become confused by trying to bring in to your analysis the X12 usage
requirements of Mandatory, Optional. As stated above, there are NO OPTIONAL
use segments, elements or codes in HIPAA.
Hope this helps.
Rachel
I thought I had all this down, but now fear that I'm losing my grasp on
these redefined values.
Loop/Segment/Element usage:
Standard 4010;
[C]onditional
[M]andatory
[O]ptional
HIPAA;
[N]ot Used
[R]equired
[S]ituational
Element Option (Requirement Designator) Attributes:
Standard 4010;
[C]onditional
[M]andatory
[O]ptional
HIPAA;
[M]andatory???
[O]ptional???
[X]Conditional/Situational???
There is a flaw in my understanding of the relationship between the usage
and option attributes.
What do these codes [M], [O] and [X] really represent?
Elements marked REQUIRED use all three codes.
Martin A. Morrison
Project Lead
HIPAA Implemention/Coordination
Blue Shield of California
80 Blue Ravine Rd.
Folsom, Ca 95630
(916) 350-8808
mailto:[EMAIL PROTECTED]
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