Full access
Government News
Published Online: 7 November 2003

Coding Help Available to Psychiatrists During HIPAA Transition Period

Publication: Psychiatric News
Volume 38, Number 21
https://doi.org/10.1176/pn.38.21.0004b
PDF/EPUB
The new HIPAA Transactions Rule required health insurers, hospitals, physicians, and claims administrators to use a uniform electronic billing system by October 16. However, the Centers for Medicare and Medicaid Services (CMS) made two important announcements in September:
• Although the administrative simplification portion of HIPAA stipulates the use of ICD-9-CM diagnostic codes in all electronic transactions, CMS has reassured psychiatrists and others that they can continue to use the diagnostic criteria found in DSM-IV to formulate diagnoses. Each of the diagnoses found in DSM-IV has been “crosswalked” to the appropriate ICD-9-CM code. Continued use of the DSM-IV codes for other purposes (for example, medical records, quality assessment, patient communications) is acceptable.
• The agency continues to accept and process health care claims that are not HIPAA compliant even though the October 16 deadline has passed. No new deadline was set when CMS made the announcement on September 23, but CMS officials said they will “regularly reassess the readiness” of providers to determine when providers must come into full compliance.
It is important to note that practices that do not do any electronic transactions are not covered under HIPAA. Medicare physicians who have small practices (defined as having fewer than 10 full-time employees) have been permitted to continue filing paper claims and, if they do this, are not bound by HIPAA regulations. If, however, a practice does any electronic transactions or has anyone else do them on their behalf (for example, a billing company), it is covered by HIPAA.
In addition, CMS announced last month that it will accept from covered entities only those Medicare claims that are electronically submitted unless there are unusual circumstances beyond the provider’s control, such as disruption in electronic service.
“You may experience occasional problems in submitting electronic claims during this transition phase,” said Becky Yowell, assistant director of the Office of Healthcare Systems and Financing. If this happens, call APA’s Office of Healthcare Systems and Financing’s Help Line at (800) 343-4671. ▪

Information & Authors

Information

Published In

Go to Psychiatric News
Psychiatric News
Volume 38 • Number 21 • November 7, 2003
Pages: 4

History

Published online: 7 November 2003
Published in print: November 7, 2003

Authors

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard
Tips for downloading citations

There are no citations for this item

View Options

View options

PDF/ePub

View PDF/ePub

Get Access

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share

×

As described within the American Psychiatric Association (APA)'s Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences. Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.