AHA Coding Clinic® for HCPCS - 2003 Issue 4; FOR your INFORMATION

HIPAA, ICD-9-CM procedure codes, and outpatient claims

The Center for Medicare & Medicaid Services clarified the use of ICD-9-CM procedure codes on outpatient claims. The following answer was provided by CMS on 10/9/2003 on its Web site: "ICD-9-CM procedure codes were named as the HIPAA standard code set for inpatient hospital procedures. The ICD-9-CM procedure codes were not named a HIPAA standard for procedures in other settings such as hospital outpatient services or other types of ambulatory services. Hospitals may capture the ICD-9-CM procedure codes for internally tracking or monitoring hospital outpatient services; but when conducting standard transactions, hospitals must use HCPCS codes to report outpatient...

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