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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.cms.gov/MedHCPCSGenInfo/
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.

ICD Diagnosis & Procedure Codes
National Center for Health Statistics (NCHS) http://www.cdc.gov/nchs/icd.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. In 2013 the HIPAA law will mandate the use of ICD-10-CM and ICD-10-PCS.

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 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/Drugs/InformationOnDrugs/ucm142438.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
The National Electronic Disease Surveillance System (NEDSS) http://www.cdc.gov/nedss/
(Note: Click on Data Models and Vocabularies to navigate to the race and ethnicity code set) This is a hierarchical code list of possible race and ethnicity codes.

UB-04 Priority (Type) of Visit and Point of Origin (note this replaces the Admission Type and Source defined in UB-92 specifications) National Uniform Billing Committee (NUBC) www.nubc.org Codes representing the priority and the source of an admission.

UB-04 Discharge Status / Patient Disposition
National Uniform Billing Committee (NUBC) www.nubc.org
Codes indicating the patient status as of the ending service date.

UB-04 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-04 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-04 Occurrence Span Codes
National Uniform Billing Committee (NUBC) www.nubc.org
A code and the related dates that identify an event that relates 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-04 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-04 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