External
Code Maintenance List
Background
Included in this list are the contacts for maintenance
of external code lists referenced and utilized in
the 837 standard as well as implementations of that
standard. The format for all entries is as follows:
External Code List Name
Maintaining Organization Contact Web Site
Annotation Text
External Code List
Current
Procedure Terminology (CPT4) Procedure Codes
American
Medical Association http://www.ama-assn.org/ama/pub/category/3113.html
A
medical code set maintained and copyrighted by the
AMA that has been selected for use under HIPAA for
non-institutional and non-dental professional transactions.
HCFA
Common Procedure Coding System (HCPCS)
Centers
for Medicare and Medicaid Services http://www.hcfa.gov/medicare/hcpcs.htm
A medical code set that identifies health care procedures, equipment, and
supplies for claim submission purposes.
These codes are currently named for use under
HIPAA.
Home
Infusion EDI Coalition (HIEC) Product/Service Code
List
National
Home Infusion Association http://www.nhianet.org/
The HIEC coding system is
adopted as the national standard for the description
and classification of infusion services. These
codes are not currently named for use under HIPAA.
ICD9-CM
Diagnosis & Procedure Codes
National
Center for Health Statistics (NCHS)
www.cdc.gov/nchs/about/otheract/icd9/abticd9.htm
ICD-9-CM is the official system of assigning codes to diagnoses and procedures
associated with hospital utilization in the United
States. These codes are currently named for use
under HIPAA.
Logical
Observation Identifier Names and Codes (LOINC)
Regenstrief
Institute http://www.regenstrief.org/loinc/
A set of universal names and ID code names that identify laboratory and
clinical observations. These codes are proposed for use under HIPAA
when the attachment transaction is published.
National
Association of Insurance Commissioners (NAIC) Codes
National
Association of Insurance Commissioners
http://www.naic.org/general.htm
A number assigned to insurance
companies who file an annual statement with the
NAIC. The National Plan ID will replace this payer
identifier when that HIPAA rule is implemented.
National
Drug Codes
Food
and Drug Administration http://www.fda.gov/cder/ndc/index.htm
This
is a list of universal product identifier for human
drugs. These
codes were originally named for use under HIPAA,
but a decision at HHS has been made to also allow
the reporting of additional drug codes.
Race
and Ethnicity Codes
Health
Information and Surveillance Systems Board (HISSB)
Centers
for Disease Control (CDC) http://www.cdc.gov/od/hissb/docs.htm
This
is a hierarchical code list of possible race and
ethnicity codes.
UB-92
Admission Source and Type
National
Uniform Billing Committee (NUBC) www.nubc.org
Codes
representing the priority and the source of an admission.
UB-92
Discharge Status / Patient Disposition
National
Uniform Billing Committee (NUBC) www.nubc.org
Codes
indicating the patient status as of the ending service
date.
UB-92
Condition Codes
National
Uniform Billing Committee (NUBC) www.nubc.org
A
code used to identify conditions relating to a bill
that may affect payer processing, such as patient
is homeless. It
should be noted that the NUBC has agreed to set
aside a range of Condition Codes for use in public
health reporting.
UB-92
Occurrence Codes
National
Uniform Billing Committee (NUBC) www.nubc.org
Code
and an associated date defining a significant event
relating to this bill that may affect payer processing,
such as an auto accident date. It should be noted
that the NUBC has agreed to set aside a range of
Occurrence Codes for use in public health
reporting.
UB-92
Occurrence Span Codes
National
Uniform Billing Committee (NUBC) www.nubc.org
A
code and the related dates that identify an event
that relates o the payment of a claim, such as Skill
Nursing Facility level of care dates. It should
be noted that the NUBC has agreed to set aside a
range of Occurrence
Span Codes for use in public health reporting.
UB-92
Revenue Codes
National
Uniform Billing Committee (NUBC) www.nubc.org
A
code which identifies a specific accommodation,
ancillary service or billing calculation, such as
emergency room charges.
UB-92
Value Codes
National
Uniform Billing Committee (NUBC) www.nubc.org
A
code structure to relate amounts or values to identified
data elements necessary to process this claim as
qualified by the payer organization, such as accident
hour. It should be noted that the NUBC has agreed
to set aside a range of
Value Codes for use in public health reporting.
Zip
Codes
United
States Postal Service www.usps.gov
