The Health Insurance Portability and Accountability Act (HIPAA) Overview-Focus on Provider Taxonomy (October 2002)

Why This Topic Matters

It helps readers understand the compliance context for electronic health care transactions and the general purpose and maintenance of the provider taxonomy used in standardized data exchange.

Article Sections

1. October 2002 pages 5-7

   Publication and issue information for the commentary.

2. Coding Commentary: The Health Insurance Portability and Accountability Act (HIPAA) Overview-Focus on Provider Taxonomy

   General overview of HIPAA administrative simplification and the transaction environment for electronic health data exchange.

3. Who must comply with the HIPAA standards?

   Broad discussion of the entities and practices that fall within the HIPAA standards framework.

4. Who must submit Medicare claims electronically?

   Overview of the Medicare electronic claims context and related compliance considerations for physician practices.

5. Who is exempt from the HIPAA standards?

   High-level summary of circumstances discussed in the article under which a physician practice may be outside the standards.

6. What Code Sets are included in the Transaction Final Rule?

   Discussion of the transaction rule’s national code set framework and how standardized data elements relate to electronic transactions.

7. The Health Care Provider Taxonomy Code Set - An Administratively Simple Way to Identify Provider Types

   Background on the provider taxonomy as an external classification system used in health care electronic transactions.

8. Code Structure

   General structure and organization of the provider taxonomy and its relationship to individual providers.

9. Code Maintenance

   Maintenance, update, and request processes described for the provider taxonomy code set.