HIPAA Uniform Codes Analysis

Initially, facilities voluntarily used HCPCS codes, but with the implementation of HIPAA in 1996, facilities began to report HCPCS for transaction codes (Webb, 2012). CPT (Current Procedural Terminology) is a medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations (Rouse, 2015). The HCPCS level II coding system has a selected standard coding system with a wide acceptance among both public and private insurers. The HCPCS level II codes set are alphanumeric code set and primarily include non-physician products, supplies, and procedures not included in CPT. For HCPCS to bill the and identify the service that are been used such as.

The electronic transactions that are covered by the rules are: Claims, Payment, Claim Status, Eligibility, Referral Certification and Coordination of Benefits. HIPAA may refer to code sets as medical codes or nonmedical codes. Typically maintained by professional organizations or other organizations.

E/M codes tell what was done in the office. Everything that the doctor or physician has done is documented, and coded. If a certain thing was not done then it should not be coded, and charged for that is considered fraud. Also everything that is done in the office must be documented, and coded using the E/M codes. If the E/M coding was done incorrectly the person would get in trouble for fraud, and not only that the office would have a bad reputation, and other insurance companies wouldn 't probably want to go through that office anymore.

HCPCS Level II codes commonly are referred to as national codes or by the acronym HCPCS, which stands for the Healthcare Common Procedure Coding System. HCPCS codes are used for billing Medicare and Medicaid patients and have been adopted by some third-party payers. These codes, updated and published annually by the Centers for Medicare and Medicaid Services (CMS), are intended to supplement the CPT coding system by including codes for nonphysician services, administration of injectable drugs, durable medical equipment (DME), and office supplies. The main terms are in boldface type in the index.

There are two Associations for Medical Coders, one is the American Health Information Management Association (AHIMA) and the other is the American Academy of Professional Coders (AAPC). AHIMA is the leading association of health information management for professionals all over the world (www.ahima.org 2015). In 1928, AHIMA was known for refining the quality of health records. “AHIMA is working to advance the implementation of electronic health records by leading key industry initiatives and advocating high and consistent standards” (www.ahima.org 2015). AHIMA 's credentials includes Certified Coding Associate (CCA)

In the states of our economy today, a need to regulate business transactions in a uniform way is necessary. UCC plays an important role to protect individuals and business. It was developed to address the increasingly complex legal and contractual requirements in today’s commercial dealings. The primary purpose of the UCC is to make business activities more predictable and efficient.

Since HIPAA become mandatory on most of the health care organization, patient information is more secure compared to previous. Health care organization are investing huge amount of fund for safety measures to protect the patient information and i think this is the main concern in today's advanced health care

This rule adopts standards for eight electronic transactions and for code sets to be used in those transactions. It also contains requirements concerning the use of these standards by health plans, health care clearinghouses, and certain health care providers. The use of these standard transactions and code sets will improve the Medicare and Medicaid programs and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the system and enabling the efficient electronic transmission of certain health information. It implements some of the requirements of the Administrative Simplification subtitle of the Health Insurance.

A core element of confidence building is showing the professionals how to value and use information adopted for coded data. This type of information has the power to describe medical necessity in support of admissions, readmission’s and continued stays. An example I would like to give is, by pinpointing

To encourage this goal nonetheless, HIPAA included "Regulatory Simplification" arrangements that ordered the Department of Health and Human Services (HHS) to receive national models for the transmission and insurance of wellbeing data. The subsequent between the year 2003 and 2013

The Health Insurance and Portability and Accountability Act ( HIPAA) of 1996 provides security provisions and data privacy for protecting a patient’s medical information. HIPAA has guidelines to ensure that a patient’s confidentiality is maintained while allowing the communication of a patient’s medical records between certain bodies or people or officials. Officials that a patient’s medical records can be shared with are other health care providers, health plans, business associates, and health care clearinghouses. HIPAA protects all “ individually identifiable health information”. There is a specific protocol to follow when sharing a patient’s medical information.

HIPAA is legislation that is mostly used in United States for the protection and privacy of the patient’s information. The medical information is protected by HIPAA whereby it ensures safe access to health and other personal information. HIPAA is therefore divided into five rules and regulations. There is private rule which ensures that all the information about individual’s health is highly protected. Private rule allows a good flow of health care information to ensure that an individual gets the best quality health care.

As records were shared electronically rules were implemented for clinicians to follow known as The Health Insurance Portability and Accountability Act (HIPAA) of 1996 (Summary of the HIPAA Security Rule ,2013). These rules were implemented for clinicians to protect the

The goals of HIPAA are to ensure medical coverage scope for workers and their families when they change or lose their employments and to secure wellbeing information trustworthiness, classification, and accessibility. The objectives are also to enhance our health care framework by making it more proficient, less difficult, and less

HIPAA’s existence constituted as a necessary health care reform. This particular healthcare reform empowered patients by giving them more control and say over the handling of medical records. The HIPAA law also reshaped how health care providers handled patients’ medical records, especially concerning patient privacy (IHS, n.d.). Under the HIPAA law, the privacy rule includes the “national standards” that health care organizations must