Which of the following code sets is NOT required as part of HIPAA administrative simplification provisions?

Which of the following code sets is NOT required as part of HIPAA administrative simplification provisions?

• A. ICD-10-CM
• B. CDT
• C. DSM
• D. CPT

Answer: (C)

The correct answer identifies the DSM, or the Diagnostic and Statistical Manual of Mental Disorders, as a code set that is not required under HIPAA’s administrative simplification provisions. Under HIPAA, the administrative simplification provisions mandate the adoption of specific code sets for electronic healthcare transactions to enhance efficiency and standardization in the healthcare system. The required code sets under HIPAA include ICD-10-CM, which is used for coding diagnoses in all healthcare settings, the Current Procedural Terminology (CPT) used for coding outpatient procedures and services, and the Code on Dental Procedures and Nomenclature (CDT) for dental services. In contrast, the DSM serves as a classification system for mental health disorders and is widely used in clinical settings for diagnostic purposes; however, it is not mandated by HIPAA for administrative simplification. Therefore, while it is an important resource in mental health care, it does not fit the requirements established under HIPAA, which focuses more on standardizing coding systems directly related to billing and clinical documentation processes.

The correct answer identifies the DSM, or the Diagnostic and Statistical Manual of Mental Disorders, as a code set that is not required under HIPAA’s administrative simplification provisions.

Under HIPAA, the administrative simplification provisions mandate the adoption of specific code sets for electronic healthcare transactions to enhance efficiency and standardization in the healthcare system. The required code sets under HIPAA include ICD-10-CM, which is used for coding diagnoses in all healthcare settings, the Current Procedural Terminology (CPT) used for coding outpatient procedures and services, and the Code on Dental Procedures and Nomenclature (CDT) for dental services.

In contrast, the DSM serves as a classification system for mental health disorders and is widely used in clinical settings for diagnostic purposes; however, it is not mandated by HIPAA for administrative simplification. Therefore, while it is an important resource in mental health care, it does not fit the requirements established under HIPAA, which focuses more on standardizing coding systems directly related to billing and clinical documentation processes.