Chris The short answer to your question is that if an element/segment/loop is marked "Not Used' then it is NOT USED. If a provider is sending you a HIPAA 4010 837 with marital status data then you can reject it as a non-HIPAA-compliant transaction. This is sort of what having a national standard is all about: everyone doing it the same way. This way you know what to spend your limited resources on: building a field for marital status on an incoming HIPAA 837 is a waste of your resources. Anyway, that's my non-official, non-legal opinion! j "Graff, Chris" wrote: > 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] > > ********************************************************************** > To be removed from this list, send a message to: [EMAIL PROTECTED] > Please note that it may take up to 72 hours to process your request.
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