The way I understand it is that if those fields are even sent on a
transaction, the sender is not HIPAA compliant. If you are using a
commercial translator, the fields will not be allowed in.
I would not store them if they are received.
John Lilleston
Business Process Specialist
Verizon Information Technologies, Inc.
813-979-3225
[EMAIL PROTECTED]
"Graff, Chris"
<[EMAIL PROTECTED] To: "'[EMAIL PROTECTED]'"
om> <[EMAIL PROTECTED]>
cc:
09/19/2001 Subject: 4010 Transaction vs. HIPAA
Compliance
04:27 PM
Please respond
to
transactions
Hello all. We are working on a HIPAA data store and claims processing
application. There is a question that has been plaguing our minds here.
If you look at the 4010X098 or 4010X096 manuals, there are many fields that
state "Not Used." Because these fields are not used, I was under the
assumption that we should not store this data. For the majority of these
fields, this is a no-brainer. Some of the NM1 loops specifically can hold
information that would never pertain to certain entities within the loop.
For instance, there is no reason to keep track of NM111(Entity
Identifier's)
for the submitter loop.
Some pieces of data, however, seem to be elements that providers or payers
may be keeping track of at the moment. One in particular that we found was
the marital status element, which is on a normal UB-92(locator 16), but is
listed as not used in the 4010X096 manual. Once we found this difference a
number of different questions came up.
1. Do we accommodate for this field because it is on the form, and there
might be a chance that this particular data element might be passed through
our processing system?
2. If we accommodate for this field, does that make us not HIPAA compliant
because we have claims running through the system that contain non-HIPAA
compliant data?
3. Should we just accommodate all the possible fields that could appear on
a 4010 even though it states in the manuals that they are specifically not
used? Once again would we then be not compliant if we did?
Any thoughts on these questions would be greatly appreciated.
Thank you,
Chris Graff
United Wisconsin Proservices
(414)226-6022
800-822-8050 x6022
[EMAIL PROTECTED]
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