E9-31216 I B 4 a

a. HIPAA Transactions and Code Sets Standards

The Secretary has previously adopted and modified transactions and code sets standards for HIPAA covered entities.

Many of these same covered entities are now also eligible to qualify for incentive payments under the Medicare and Medicaid EHR Incentives Program.

As a result, we want to assure that Certified EHR Technology positions these eligible professionals and eligible hospitals to qualify for incentive payments and comply with these transactions and code set standards.

Most recently, in August 2008, HHS proposed through two rules (73 FR 49742 and 73 FR 49796) the updating of electronic transaction standards, new transaction standards, and the adoption of International Classification of Diseases (ICD), 10th Revision, Related Health Problems (ICD-10-CM) and ICD, 10th Revision, Procedure Coding System (ICD-10-PSC) code sets to replace the ICD, 9th Revision, Clinical Modifications (ICD-9-CM) Volumes 1 and 2, and the ICD-9-CM Volume 3 code sets, respectively.

After reviewing and considering public comments on these proposals, in January 2009, HHS adopted in final rules published at 74 FR 3296 and 74 FR 3328 certain updated transaction standards, new transaction standards, and code sets.

The rules established a timeline for compliance with some of these updated standards and code sets. For example, all HIPAA covered entities are required to comply with ICD-10-CM and ICD-10-PSC on and after October 1, 2013.

In adopting an initial set of standards and implementation specifications as specified at section 3004(b)(1) of the PHSA, we have taken into account HIPAA transactions and code sets standards and their associated implementation timetables.

We have ensured that our standards and implementation specifications are consistent with the previously adopted HIPAA transactions and code sets standards and with the established implementation timetable.

Further, we intend for our future adoption of standards and implementation specifications for meaningful use Stage 2 and Stage 3 to continue to be consistent with the Secretary's adoption and modification of HIPAA transactions and code sets standards and their timeframes for compliance.