by Find-A-Code™
Sep 27th, 2023
The ICD-10 code set is one that medical coders and billers are intimately familiar with. It is arguably the most utilized code set in all medical billing. Last year, the set was updated with three new codes relating to COVID vaccination status. More than one coding specialist has openly wondered why the additions were made.
As you might expect, it did not take long for some people to jump on the conspiracy bandwagon, assuming that the federal government was using the new ICD-10 codes to track people in relation to their vaccination status. But a fact check piece published by USA Today tells the real story. The truth boils down to how the codes are utilized in light of Health Insurance Portability and Accountability Act (HIPAA) regulations.
An Introduction to HIPAA
The HIPAA of 1996 is a piece of legislation enacted to protect patient privacy. Under the legislation, certain 'covered entities' are limited in terms of how they can access and disclose patient information. HIPAA limits the free flow of private information within the medical system.
It also gives patients considerably more control over how their health information is collected, stored, and shared. Covered entities must give patients the opportunity to exercise control. They must honor patient decisions in that regard. Now, let us apply this to the ICD-10 codes for COVID vaccination status.
Covered Entities Must Use the Codes
Since 2015, all covered entities have been required to utilize ICD-10 codes for billing purposes. The same covered entities must now use the COVID vaccination codes as well. According to USA Today, those three codes are as follows:
If you haven't been to the doctor since the start of the COVID-19 pandemic, your vaccination status probably won't be in your records. Expect your doctor to ask you about it. The appropriate code will be entered into your record based on your answer.
The Information Remains Protected
Like all the other information in your health records, information about your COVID vaccination status remains protected under HIPAA. In simple terms, this means your doctor and his/her staff are not legally allowed to share the information freely. Under the limited circumstances through which your vaccination status could be shared, your identifying information still cannot be attached.
Let us say the federal government wanted to track the total number of unvaccinated and partially vaccinated adults. They can request those hard numbers from healthcare providers. But all they would get are the numbers. There would be no names attached to the numbers.
Tracking Vaccination Efficacy
Without names, it might seem pointless to track COVID vaccination status. It is anything but. By tracking raw numbers against ongoing COVID cases, the CDC is able to analyze vaccine efficacy. That is the whole point of including the new ICD-10 codes. The CDC wants to know whether vaccination is accomplishing anything.
Other federal agencies might have valid uses for the vaccination status information. But according to federal law, they are only given access to the least amount of information they need to achieve their goals. That would exclude personally identifying information in nearly every case.
For more than a year, covered entities under HIPAA are required to utilize the new ICD-10 codes for COVID vaccination status. The codes exist merely for the purposes of tracking vaccination efficacy. While the information could be used improperly, at least in theory, HIPAA regulations are in place to protect patient privacy. In short, there is no need for worry in relation to the new codes.
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