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Department of Health and Human Services

NATIONAL COMMITTEE ON VITAL AND HEALTH STATISTICS

Subcommittee on Standards

December 9-10, 2009

Industry Preparations for the Updated HIPAA Standards and Code Sets

Hubert H. Humphrey Building , Room 505A
200 Independent Avenue, SW
Washington , D.C.

Meeting Minutes


The National Committee on Vital and Health Statistics Subcommittee on Standards and Security was convened on December 9 -10, 2009 at the Hubert H. Humphrey Building in Washington, D.C. The meeting was open to the public.

Present:

Committee Members

  • Jeffrey S. Blair, M.B.A., Co-Chair
  • Judith Warren, Ph.D., R.N., Co-Chair
  • Justine M. Carr, M.D.
  • Harry L. Reynolds, Jr.
  • Anthony D. Rodgers, M.S.P.H.
  • Walter G. Suarez, M.D., M.P.H.

Absent

  • J. Marc Overhage, M.D., Ph.D.

Staff and Liaisons

  • Jeannine Christiani, Affirma Solutions
  • Lorraine T. Doo, M.P.H., CMS
  • J. Michael Fitzmaurice, Ph.D., AHRQ
  • Marjorie Greenberg, NCHS/CDC, Executive Secretary
  • Missy Jamison, NCHS
  • Katherine Jones, NCHS
  • Donna Pickett, NCHS/CDC
  • Jim Sorace, M.D., ASPE
  • Marietta Squire, NCHS
  • Karen Trudel, CMS
  • Michelle Williamson, NCHS

Presenters and Others

December 9, 2009

  • Don Bechtel, WEDI
  • Denise Buenning, MSM, CMS
  • Cathy Carter, CMS
  • Chanda Chaay, CASET
  • David Conley, AAPC
  • Todd Couts, Noblis
  • Deborah Crider, AAPC
  • Richard Cullen, BCBSA
  • Michelle Davidson, Walgreens
  • Michael DeCarlo, BCBSA
  • James J. Figge, NY state Medicaid Agency (by phone)
  • Sandra Fuller, AHIMA
  • Annette Gabel, Medco
  • Lynne Gilbertson, NCPDP
  • Deborah Grider, AAPC
  • Patrice Kuppe, Allina (by phone)
  • Larry Larson, AHIP
  • James Mechan, Emdeon
  • Stan Nachimson, WEDI
  • Miriam Paramore, Emdeon
  • Laurie Parst, WEDI
  • Tony Rogers, Health Management Associates
  • Patrice Scheyer, DISA
  • Sunny Singh, Edifecs
  • Nancy Spector, AMA
  • Mary Stanfill, AHIMA
  • Allison Viola, AHIMA
  • Eric Wallace, Linxus

December 10, 2009

  • George Arges, AHA
  • Bob Burleigh, CMS
  • Dan Cobb, HealthMedX
  • David Connolly, AAPL
  • Jerry C. Connors, DISA
  • Rich Cullen, BCBSA
  • Michelle Davidson, Walgreens
  • Michael DeCarlo, BCBSA
  • Alec Dicks, Gartner
  • Tom Dowd, Gartner
  • Bill Finerbrock, CAI
  • Sandra Fuller, AHIMA
  • Annette Gabel, Medco
  • Lynne Gilbertson, NCPDP
  • Catherine Graeff, NMEH
  • Edward A. Hafner, Foresight
  • Sid Hebert, AHIP
  • Donald Horton, ACLA/Labcorp
  • Manish Igebia, Edifecs
  • Annessa Kirby, NASL
  • Herb Larsen, Edifecs
  • Larry Larsen, AHIP
  • Tom Leary, HIMSS
  • Holly Louie, HBMA
  • James Mechan, Emdeon
  • Joe Miller, HIMSS
  • Tom Meyers, AHIP
  • Scott Ransom, Brookdale Senior Living
  • Mari Savickis, AMA
  • Patrice Scheyer, DISA
  • Sunny Singh, Edifecs
  • Nancy Spector, AMA
  • Mary Stanfill, AHIMA
  • Allison Viola, AHIMA
  • Mark Williams, PWC

EXECUTIVE SUMMARY

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ACTIONS

  1. The Subcommittee will complete a letter to the Secretary by February 2010.
  2. Subcommittee members were asked to send recommendations to Dr. Warren or Lorraine Doo for a letter to the Secretary within one week.
  3. Subcommittee members were asked to submit names to Dr. Warren or Lorraine Doo of others to submit further testimony to the group.
  4. Dr. Sorace will send the Subcommittee information about insurer observer variability, coding and SNOMED.
  5. Ms. Buenning will get back to the Subcommittee about state-specific claims codes.
  6. HBMA will share recent survey results with the Subcommittee.
  7. Ms. Greenberg suggested that the Subcommittee review the basic principles of mapping as articulated by NOM.

Wednesday, December 9, 2009

CALL TO ORDER, WELCOME, INTRODUCTIONS, AGENDA REVIEW

The purpose of these hearings is to help the Subcommittee understand the current status of implementation of HIPAA modification regulations 5010, D.0, 3.0 and the ICD-10 code sets.

PANEL I Medicare Fee-for-Service: CMS Strategies for Implementing HIPAA – Cathy Carter CMS

Topics covered included: implementation scope and scope enhancements; early project collaboration and work; project impact assessment; next steps undertaken; 5010 timeline; the status of MAC “front-end” systems; “core” systems; and “downstream” systems; primary project risks and risk mitigation; and communications. The Medicare fee-for-service program is on target for a timely and successful HIPAA 5010/D.0 implementation.

  • Denise Buenning CMS Strategies for Implementing HIPAA
  • Todd Couts Noblis

CMS’s progress with internal and external implementation of ICD-10 code sets was described. The presentation covered: CMS’s dual role in ICD-10/5010 relative to internal and external implementation; impact analysis components and findings; a claims processing business process model; the CMS ICD-10 program timeline; and program management including key activities.

Discussion The 5010 process represents the first time CMS has transitioned to a new code set. Industry readiness was addressed as were the implications of using a front-end 5010 process operating at each MAC, lessening the need for companion guides. Concerns were raised about the impact of a transition from 4010 to 5010. The benefits of front-end standardiza