Exploring HIPAA and HITECH Act Definitions: Part 1

From now through November, HIPAA.com is providing a run through of HIPAA transaction & code set, privacy, and security definitions, along with relevant HITECH Act definitions pertaining to breach notification and securing of protected health information. These definitions are key to understanding the referenced HIPAA and HITECH Act enabling regulations that are effective now and that will require compliance by covered entities and business associates now or in the months ahead, as indicated in HIPAA.com’s timeline. Each posting will contain three definitions, with a date reference to the Federal Register and citation to the Code of Federal Regulations (CFR).

We begin the first series of postings with definitions from “Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA); Final Rules,” Federal Register,  January 16, 2009.  45 CFR 162, Administrative Requirements:  162.103, Definitions.

Code Set

Any set of codes used to encode data elements, such as tables of terms, medical concepts, medical diagnostic codes, or medical procedure codes.  A code set includes the codes and the descriptors of the codes.

Code Set Maintaining Organization

An organization that creates and maintains the code sets adopted by the Secretary [of HHS] for use in the transactions for which standards are adopted in this part [162].

Data Condition

The rule that describes the circumstances under which a covered entity must use a particular data element or segment.

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