Health Information Management

HIPAA Q&A: You've got questions. We've got answers!

HIM-HIPAA Insider, September 28, 2015

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Q. As I recall, the HIPAA standards known as version 5010 had some impact on HIPAA standard transactions and code sets in relation to ICD-10. Will the overall transition to ICD-10 have any impact on HIPAA rules and regulations? Why or why not?

A. HIPAA stands for Health Insurance Portability and Accountability Act and was designed to “administratively simplify” the claims process. (Privacy and security were afterthoughts—hard to believe now!).


The 5010 transaction codes were designed to adopt one set of codes and rules for claim submission, in order to make billing easier. With the implementation of ICD-10, the requirements for ICD-9 coding will change to ICD-10-CM in the 5010 standards, and ICD-10-PCS for inpatient procedures. CPT can still be used for outpatient procedures. There will be no change to the privacy, security, HITECH, or omnibus rules, at least that we are aware of now.


Editor’s note: Chris Simons, MS, RHIA, director of HIM and privacy officer at Maine General Medical Center, answered this question for HCPro’s Medical Records Briefing newsletter. This information does not constitute legal advice. Consult legal counsel for answers to specific privacy and security questions.



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