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Code Sets

The Health Insurance Portability and Accountability Act (HIPAA) Transactions, Code Sets and Identifiers (TCS&I) Office facilitates the implementation of nationwide standards of code sets used in the HIPAA-compliant electronic health care transactions for the Military Health System (MHS).

In addition to the Medical Data Code Sets adopted in the Transactions and Code Sets Final Rule, the following are examples of administrative code sets that are also required in the HIPAA Implementation Guides: 

  • Health Care Provider Taxonomy Codes
  • Country Codes (International Organization of Standards [ISO] 3166)
  • Claim Adjustment Reason Codes
  • Place of Service Codes
  • Claim Status Codes

ICD-10 was adopted initially as a code set in January 2009 when the Centers for Medicare and Medicaid Services (CMS) issued the original ICD-10 Final Rule. The MHS enterprise successfully transitioned to the use of ICD-10 on October 1, 2015.

Frequently Asked Questions

Q1:

How do I know how to correctly code my claim?

A:
Q2:

What organization developed the ICD-10 code set?

A:

The World Health Organization (WHO), a specialized agency of the United Nations, owns and publishes the ICD code sets (including ICD-10).

Q4:

Why are code sets used in nationwide electronic health care transactions?

A:

By using standardized code sets, providers across the nation can easily and efficiently communicate with one another in order to serve patients and conduct administrative transactions.  In other words, the use of standardized code sets improves the interoperability of health care payers and providers by normalizing the “language” that is used.

You also may be interested in...

New coding system gives military health care providers more flexibility, specificity in ailment ID

Article
6/21/2016
ICD-10 allows health care staff to document more specifically what a disease or injury is and where it is on a person’s body.

Military health care providers are now using a new system to better document ailments and injuries. ICD-10 replaces an aging set of codes not fit anymore for modern diagnoses and treatments.

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International Classification of Diseases, Tenth Revision (ICD-10) | Code Sets | Health IT Research and Innovation Strategy
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