|
Code
|
Description
|
Comment
|
Version
|
| 001
|
Release of Information/MR / Authorization to Disclosure Protected Health Information |
Release of Info/ Disclosure |
added v2.5 |
| 002
|
Medical Procedure (invasive) |
Medical Treatment/ Procedure |
added v2.5 |
| 003
|
Acknowledge Receipt of Privacy Notice |
Acknowledgement/ Notification |
added v2.5 |
| 004
|
Abortion |
Medical Treatment/ Procedure |
added v2.5 |
| 005
|
Abortion/Laminaria |
Medical Treatment/ Procedure |
added v2.5 |
| 006
|
Accutane - Information |
Medical Treatment/ Procedure |
added v2.5 |
| 007
|
Accutane - Woman |
Medical Treatment/ Procedure |
added v2.5 |
| 008
|
Advanced Beneficiary Notice |
Acknowledgement/ Notification |
added v2.5 |
| 009
|
AFP (Alpha Fetoprotein) Screening |
Medical Treatment/ Procedure |
added v2.5 |
| 010
|
Amniocentesis (consent & refusal) |
Medical Treatment/ Procedure |
added v2.5 |
| 011
|
Anatomical Gift (organ donation) |
Administrative |
added v2.5 |
| 012
|
Anesthesia - Complications |
Medical Treatment/ Procedure |
added v2.5 |
| 013
|
Anesthesia - Questionnaire |
Medical Treatment/ Procedure |
added v2.5 |
| 014
|
Angiogram |
Medical Treatment/ Procedure |
added v2.5 |
| 015
|
Angioplasty |
Medical Treatment/ Procedure |
added v2.5 |
| 016
|
Anticancer Drugs |
Medical Treatment/ Procedure |
added v2.5 |
| 017
|
Antipsychotic Medications |
Medical Treatment/ Procedure |
added v2.5 |
| 018
|
Arthrogram |
Medical Treatment/ Procedure |
added v2.5 |
| 019
|
Autopsy |
Administrative |
added v2.5 |
| 020
|
AZT Therapy |
Medical Treatment/ Procedure |
added v2.5 |
| 021
|
Biliary Drainage |
Medical Treatment/ Procedure |
added v2.5 |
| 022
|
Biliary Stone Extraction |
Medical Treatment/ Procedure |
added v2.5 |
| 023
|
Biopsy |
Medical Treatment/ Procedure |
added v2.5 |
| 024
|
Bleeding Time Test |
Medical Treatment/ Procedure |
added v2.5 |
| 025
|
Bronchogram |
Medical Treatment/ Procedure |
added v2.5 |
| 026
|
Cardiac Catheterization |
Medical Treatment/ Procedure |
added v2.5 |
| 027
|
Coronary Angiography |
Medical Treatment/ Procedure |
added v2.5 |
| 028
|
"" "" w/o Surgery Capability |
Medical Treatment/ Procedure |
added v2.5 |
| 029
|
Cataract Op/Implant of FDA Aprvd Lens |
Medical Treatment/ Procedure |
added v2.5 |
| 030
|
Cataract Op/Implant of Investigational Lens |
Medical Treatment/ Procedure |
added v2.5 |
| 031
|
Cataract Surgery |
Medical Treatment/ Procedure |
added v2.5 |
| 032
|
Cholera Immunization |
Medical Treatment/ Procedure |
added v2.5 |
| 033
|
Cholesterol Screening |
Medical Treatment/ Procedure |
added v2.5 |
| 034
|
Circumcision - Newborn |
Medical Treatment/ Procedure |
added v2.5 |
| 035
|
Colonoscopy |
Medical Treatment/ Procedure |
added v2.5 |
| 036
|
Contact Lenses |
Medical Treatment/ Procedure |
added v2.5 |
| 037
|
CT Scan - Cervical & Lumbar |
Medical Treatment/ Procedure |
added v2.5 |
| 038
|
CT Scan w/ IV Contrast Media into Vein |
Medical Treatment/ Procedure |
added v2.5 |
| 039
|
CVS (Chorionic Villus) Sampling |
Medical Treatment/ Procedure |
added v2.5 |
| 040
|
Cystospy |
Medical Treatment/ Procedure |
added v2.5 |
| 041
|
Disclosure of Protected Health Information to Family/Friends |
Release of Info/ Disclosure |
added v2.5 |
| 042
|
D & C and Conization |
Medical Treatment/ Procedure |
added v2.5 |
| 043
|
Dacryocystogram |
Medical Treatment/ Procedure |
added v2.5 |
| 044
|
Diagnostic Isotope |
Medical Treatment/ Procedure |
added v2.5 |
| 045
|
Drainage of an Abscess |
Medical Treatment/ Procedure |
added v2.5 |
| 046
|
Drug Screening |
Medical Treatment/ Procedure |
added v2.5 |
| 047
|
Electronic Monitoring of Labor - Refusal |
Medical Treatment/ Procedure |
added v2.5 |
| 048
|
Endometrial Biopsy |
Medical Treatment/ Procedure |
added v2.5 |
| 049
|
Endoscopy/Sclerosis of Esophageal Varices |
Medical Treatment/ Procedure |
added v2.5 |
| 050
|
ERCP |
Medical Treatment/ Procedure |
added v2.5 |
| 051
|
Exposure to reportable Communicable Disease |
Medical Treatment/ Procedure |
added v2.5 |
| 052
|
External Version |
Medical Treatment/ Procedure |
added v2.5 |
| 053
|
Fluorescein Angioscopy |
Medical Treatment/ Procedure |
added v2.5 |
| 054
|
Hepatitis B - Consent/Declination |
Medical Treatment/ Procedure |
added v2.5 |
| 055
|
Herniogram |
Medical Treatment/ Procedure |
added v2.5 |
| 056
|
HIV Test - Consent Refusal |
Medical Treatment/ Procedure |
added v2.5 |
| 057
|
HIV Test - Disclosure |
Medical Treatment/ Procedure |
added v2.5 |
| 058
|
HIV Test - Prenatal |
Medical Treatment/ Procedure |
added v2.5 |
| 059
|
Home IV Treatment Program |
Medical Treatment/ Procedure |
added v2.5 |
| 060
|
Home Parenteral Treatment Program |
Medical Treatment/ Procedure |
added v2.5 |
| 061
|
Hysterectomy |
Medical Treatment/ Procedure |
added v2.5 |
| 062
|
Hysterosalpingogram |
Medical Treatment/ Procedure |
added v2.5 |
| 063
|
Injection Slip/ Consent |
Medical Treatment/ Procedure |
added v2.5 |
| 064
|
Intrauterine Device |
Medical Treatment/ Procedure |
added v2.5 |
| 065
|
Intrauterine Device/Sterilization |
Medical Treatment/ Procedure |
added v2.5 |
| 066
|
Intravascular Infusion of Streptokinase/Urokinase |
Medical Treatment/ Procedure |
added v2.5 |
| 067
|
Intravenous Cholangiogram |
Medical Treatment/ Procedure |
added v2.5 |
| 068
|
Intravenous Digital Angiography |
Medical Treatment/ Procedure |
added v2.5 |
| 069
|
Iodine Administration |
Medical Treatment/ Procedure |
added v2.5 |
| 070
|
ISG |
Medical Treatment/ Procedure |
added v2.5 |
| 071
|
IVP |
Medical Treatment/ Procedure |
added v2.5 |
| 072
|
Laser Photocoagulation |
Medical Treatment/ Procedure |
added v2.5 |
| 073
|
Laser treatment |
Medical Treatment/ Procedure |
added v2.5 |
| 074
|
Lithium Carbonate |
Medical Treatment/ Procedure |
added v2.5 |
| 075
|
Liver Biopsy |
Medical Treatment/ Procedure |
added v2.5 |
| 076
|
Lumbar Puncture |
Medical Treatment/ Procedure |
added v2.5 |
| 077
|
Lymphangiogram |
Medical Treatment/ Procedure |
added v2.5 |
| 078
|
MAO Inhibitors |
Medical Treatment/ Procedure |
added v2.5 |
| 079
|
Med, Psych, and/or Drug/Alcohol |
Release of Info/ Disclosure |
added v2.5 |
| 080
|
Medical Treatment - Refusal |
Administrative |
added v2.5 |
| 081
|
Morning-after Pill |
Medical Treatment/ Procedure |
added v2.5 |
| 082
|
MRI - Adult |
Medical Treatment/ Procedure |
added v2.5 |
| 083
|
MRI - Pediatric |
Medical Treatment/ Procedure |
added v2.5 |
| 084
|
Myelogram |
Medical Treatment/ Procedure |
added v2.5 |
| 085
|
Needle Biopsy |
Medical Treatment/ Procedure |
added v2.5 |
| 086
|
Needle Biopsy of Lung |
Medical Treatment/ Procedure |
added v2.5 |
| 087
|
Newborn Treatment and Release |
Medical Treatment/ Procedure |
added v2.5 |
| 088
|
Norplant Subdermal Birth Control Implant |
Medical Treatment/ Procedure |
added v2.5 |
| 089
|
Operations, Anesthesia, Transfusions |
Medical Treatment/ Procedure |
added v2.5 |
| 090
|
Oral Contraceptives |
Medical Treatment/ Procedure |
added v2.5 |
| 091
|
Organ Donation |
Administrative |
added v2.5 |
| 092
|
Patient Permits, Consents |
Administrative |
added v2.5 |
| 093
|
Patient Treatment Permit, Release & Admission |
Administrative |
added v2.5 |
| 094
|
Penile Injections |
Medical Treatment/ Procedure |
added v2.5 |
| 095
|
Percutaneous Nephrostomy |
Medical Treatment/ Procedure |
added v2.5 |
| 096
|
Percutaneous Transhepatic Cholangiogram |
Medical Treatment/ Procedure |
added v2.5 |
| 097
|
Photographs |
Release of Info/ Disclosure |
added v2.5 |
| 098
|
Photographs - Employee |
Release of Info/ Disclosure |
added v2.5 |
| 099
|
Photographs - Medical Research |
Release of Info/ Disclosure |
added v2.5 |
| 100
|
Photographs - news Media |
Release of Info/ Disclosure |
added v2.5 |
| 101
|
Psychiatric Admission - Next of Kin |
Medical Treatment/ Procedure |
added v2.5 |
| 102
|
Psychiatric Information During Hospital Stay |
Release of Info/ Disclosure |
added v2.5 |
| 103
|
Public Release of Information |
Release of Info/ Disclosure |
added v2.5 |
| 104
|
Radiologic Procedure |
Medical Treatment/ Procedure |
added v2.5 |
| 105
|
Refusal of Treatment |
Administrative |
added v2.5 |
| 106
|
Release of Body |
Administrative |
added v2.5 |
| 107
|
Release of Limb |
Administrative |
added v2.5 |
| 108
|
Rh Immune Globulin |
Medical Treatment/ Procedure |
added v2.5 |
| 109
|
Rights of Medical Research Participants |
Administrative |
added v2.5 |
| 110
|
Request to Restrict Access/Disclosure to Medical Record/Protected Health Information |
Release of Info/ Disclosure |
added v2.5 |
| 111
|
Request for Remain Anonymous |
Release of Info/ Disclosure |
added v2.5 |
| 112
|
Seat Belt Exemption |
Administrative |
added v2.5 |
| 113
|
Sialogram |
Medical Treatment/ Procedure |
added v2.5 |
| 1137
|
Voiding Cystogram |
Medical Treatment/ Procedure |
added v2.5 |
| 114
|
Sigmoidoscopy |
Medical Treatment/ Procedure |
added v2.5 |
| 115
|
Sterilization - Anesthesia & Medical Services |
Medical Treatment/ Procedure |
added v2.5 |
| 116
|
Sterilization -Federally Funded |
Medical Treatment/ Procedure |
added v2.5 |
| 117
|
Sterilization - Female |
Medical Treatment/ Procedure |
added v2.5 |
| 118
|
Sterilization - Laparoscopy/Pomeroy |
Medical Treatment/ Procedure |
added v2.5 |
| 119
|
Sterilization - Non-Federally Funded |
Medical Treatment/ Procedure |
added v2.5 |
| 120
|
Sterilization - Secondary |
Medical Treatment/ Procedure |
added v2.5 |
| 121
|
Tranquilizers |
Medical Treatment/ Procedure |
added v2.5 |
| 122
|
Transfer - Acknowledgement |
Medical Treatment/ Procedure |
added v2.5 |
| 123
|
Transfer - Authorization |
Medical Treatment/ Procedure |
added v2.5 |
| 124
|
Transfer Certification - Physician |
Medical Treatment/ Procedure |
added v2.5 |
| 125
|
Transfer/Discharge Request |
Medical Treatment/ Procedure |
added v2.5 |
| 126
|
Transfer for Non-Medical Reasons |
Medical Treatment/ Procedure |
added v2.5 |
| 127
|
Transfer - Interfaculty Neonatal |
Medical Treatment/ Procedure |
added v2.5 |
| 128
|
Transfer Refusal |
Medical Treatment/ Procedure |
added v2.5 |
| 129
|
Transfer Refusal of Further Treatment |
Medical Treatment/ Procedure |
added v2.5 |
| 130
|
Treadmill & EKG |
Medical Treatment/ Procedure |
added v2.5 |
| 131
|
Treadmill, Thallium-201 |
Medical Treatment/ Procedure |
added v2.5 |
| 132
|
Typhoid |
Medical Treatment/ Procedure |
added v2.5 |
| 133
|
Use of Investigational Device |
Medical Treatment/ Procedure |
added v2.5 |
| 134
|
Use of Investigational Drug |
Medical Treatment/ Procedure |
added v2.5 |
| 135
|
Venogram |
Medical Treatment/ Procedure |
added v2.5 |
| 136
|
Videotape |
Release of Info/ Disclosure |
added v2.5 |