There is some discussion about this issue on the FAQ portion of the DHHS 
administrative simplification website. See 
http://aspe.hhs.gov/admnsimp/faqtx.htm#docsdefinecases

>From the DHHS website:
Such additional information (in companion guides) may not be used to modify the 
standard and may not include:

Instructions to modify the definition, condition, or use of a data element or segment 
in the HIPAA standard implementation guide. 
Requests for data elements or segments that are not stipulated in the HIPAA standard 
implementation guide. 
Requests for codes or data values that are not valid based on the HIPAA standard 
implementation guide. Such codes or values could be invalid because they are marked 
not used in the implementation guide or because they are simply not mentioned in the 
guide. 
Change the meaning or intent of a HIPAA standard implementation guide. 

My opinion relative to your questions: A situational loop, segment or data element in 
the Implementation Guides (IG) has the conditions for usage or non-usage defined in 
the IG. In situations that are ambiguous and in the absence of further official 
clarification regarding the defined situation, I expect a conversation would need to 
occur between trading partners to ensure a mutual understanding of the situation. I do 
not believe the intent of HIPAA is to allow a trading partner to unilaterally declare 
a situational data element, segment, or loop required.

If a data element or segment is defined as "NOT USED" in the IG, then that's exactly 
what that means. You CANNOT use it. It is as if that particular item isn't even in the 
guide. 

I've run into situations where some folks want to use codes (from internal X12 code 
lists) that are not defined in the IG but happen to be available in version release 
4010 of the X12 standards. This isn't permitted either.

Paul Weber
916-449-6970



----- Original Message -----
From: Janie Miller <[EMAIL PROTECTED]>
Date: Thu, 11 Jul 2002 13:01:51 -0700
To: "''[EMAIL PROTECTED]''" <[EMAIL PROTECTED]>
Subject: req vs. situation - companion documents


> Probably ignorant questions, but I must clarify for my own sanity:
> 
> In a companion document, is it HIPAA compliant for a covered entity to
> "require" certain "situational" loops/segments/data elements of its trading
> partner(s)?  What about when the covered entity wants to "require" certain
> specific data in "NOT USED" description fields?
> 
> 
> 
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