I would have a hard time describing what I think is legal or illegal in a companion guide. I could better tell if I saw a few examples. But like Justice Potter Stewart said when he admitted he couldn't really describe obscenity, "I know it when I see it..."
Most, if not all, of the situational notes I've seen in the HIPAA IGs seem to have their required uses specified - so the sender should know ahead of time what to stick in such elements or when to use such segments. For example, it's not up to the payer to dictate when the situational middle name should be sent - instead, the provider sends it if he has it; in effect, it's up to the sender's discretion. I think most anything that smacks of IG-type language in a companion guide is illegal. As an example, I think it's okay for you, as a payer, to say that you will process up to four diagnosis codes per claim; that's a subtle (or not so subtle) difference from saying HI05 through HI08 may not be used. My concern, as always, is for the poor provider: trading partner specific stuff could end up requiring him to need more than one map for any particular transaction set or function. William J. Kammerer Novannet, LLC. Columbus, US-OH 43221-3859 +1 (614) 487-0320 ----- Original Message ----- From: "Rachel Foerster" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, 17 July, 2002 03:20 PM Subject: RE: Testing for levels 3, 4, and 6 Of course trading partner specific stuff is legal....this is where much of the situational items are defined. The only prohibition is that any trading partner specific stuff not violate any of the HIPAA specifications. It's the trading partner specific stuff (most often from the payer) that results in companion documents which give guidance to the providers such that when they submit a HIPAA compliant claim it can pass through the payer's adjudication system as cleanly as possible. After all, the goal is not to send a HIPAA complaint claim, the goal is to get paid! Rachel Rachel Foerster Principal Rachel Foerster & Associates, Ltd. Professionals in EDI & Electronic Commerce 39432 North Avenue Beach Park, IL 60099 Phone: 847-872-8070 Fax: 847-872-6860 http://www.rfa-edi.com -----Original Message----- From: William J. Kammerer [mailto:[EMAIL PROTECTED]] Sent: Tuesday, July 16, 2002 9:07 PM To: [EMAIL PROTECTED] Subject: Re: Testing for levels 3, 4, and 6 Chris: Can we take this discussion to one or the other of the WEDI/SNIP mailing lists, in order to avoid cross-posting? I suggest "Transactions," simply because discussion may uncover bigger issues than simply testing. Having said that, I'm sure the various purveyors of HIPAA validation tools and services must have the HIPAA IGs in some machine readable format, replete with business rules and access to standard code sets. Otherwise, they wouldn't be able to do HIPAA compliance testing (unless they had really lousy programmers who hard coded everything in their application code!!). So the stuff (machine readable IGs) obviously exists - though the vendors may treat these materials as valuable intellectual property, considering a lot of business knowledge is tied up in them. And once an IG has been codified in some interoperable standard, like SEF, it is not rocket science to produce an IMPDEF version (or vice versa). But I really want to know just what the heck anyone else (besides testing or translator vendors) would want with machine readable HIPAA IGs? Why would a payer or provider want to promulgate her own "subsets" of the HIPAA IGs? What kind of trading partner specific junk would you expect to see in one of these? Is trading-partner specific stuff even legal under HIPAA? William J. Kammerer Novannet, LLC. Columbus, US-OH 43221-3859 +1 (614) 487-0320 ********************************************************************** 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. ====================================================== The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
