HIPAA Transactions and Code Sets standards authority
E717990
HIPAA Transactions and Code Sets standards authority is the regulatory framework that governs the uniform electronic exchange of healthcare administrative and financial data in the United States.
Statements (47)
| Predicate | Object |
|---|---|
| instanceOf |
HIPAA standard
ⓘ
regulatory framework ⓘ |
| appliesTo |
electronic healthcare administrative data
ⓘ
electronic healthcare financial data ⓘ |
| basedOn |
HIPAA Administrative Simplification provisions
ⓘ
Health Insurance Portability and Accountability Act NERFINISHED ⓘ |
| codeSetStandard |
CDT dental codes
NERFINISHED
ⓘ
CPT codes ⓘ HCPCS codes NERFINISHED ⓘ ICD diagnosis codes ⓘ ICD procedure codes ⓘ NDC drug codes ⓘ |
| complianceRequiredFor |
business associates of covered entities
ⓘ
covered entities ⓘ |
| country |
United States of America
ⓘ
surface form:
United States
|
| dataType |
administrative data
ⓘ
claims data ⓘ eligibility data ⓘ financial data ⓘ payment data ⓘ |
| enforcedBy |
Centers for Medicare & Medicaid Services
NERFINISHED
ⓘ
U.S. Department of Health and Human Services NERFINISHED ⓘ |
| goal |
administrative simplification
ⓘ
uniform electronic exchange of healthcare data ⓘ |
| governs |
standard electronic healthcare transactions
ⓘ
standard medical code sets ⓘ |
| legalBasis | federal regulation ⓘ |
| objective |
improve efficiency of healthcare transactions
ⓘ
promote interoperability ⓘ reduce administrative costs ⓘ |
| regulates |
certain healthcare providers
ⓘ
health plans ⓘ healthcare clearinghouses ⓘ |
| relatedTo |
HIPAA Privacy Rule
NERFINISHED
ⓘ
HIPAA Security Rule NERFINISHED ⓘ |
| requiresUseOf |
standard medical code sets
ⓘ
standard transaction formats ⓘ |
| scope | electronic transactions only ⓘ |
| sector | healthcare ⓘ |
| transactionStandard |
claim status inquiries
ⓘ
claims ⓘ coordination of benefits ⓘ eligibility inquiries ⓘ enrollment and disenrollment ⓘ payment and remittance advice ⓘ premium payment ⓘ referral authorization ⓘ |
Referenced by (1)
Full triples — surface form annotated when it differs from this entity's canonical label.