[Code of Federal Regulations]

[Title 45, Volume 1]

[Revised as of October 1, 2001]

From the U.S. Government Printing Office via GPO Access

[CITE: 45CFR162.103]



[Page 675-676]

 

                        TITLE 45--PUBLIC WELFARE

 

                    SUBTITLE A--DEPARTMENT OF HEALTH

                           AND HUMAN SERVICES

 

PART 162--ADMINISTRATIVE REQUIREMENTS--Table of Contents

 

                      Subpart A--General Provisions

 

Sec. 162.103  Definitions.



    For purposes of this part, the following definitions apply:

    Code set means any set of codes used to encode data elements, such 

as tables of terms, medical concepts, medical diagnostic codes, or 

medical procedure codes. A code set includes the codes and the 

descriptors of the codes.

    Code set maintaining organization means an organization that creates 

and maintains the code sets adopted by the Secretary for use in the 

transactions for which standards are adopted in this part.

    Data condition means the rule that describes the circumstances under 

which a covered entity must use a particular data element or segment.

    Data content means all the data elements and code sets inherent to a 

transaction, and not related to the format of the transaction. Data 

elements that are related to the format are not data content.

    Data element means the smallest named unit of information in a 

transaction.

    Data set means a semantically meaningful unit of information 

exchanged between two parties to a transaction.

    Descriptor means the text defining a code.

    Designated standard maintenance organization (DSMO) means an 

organization designated by the Secretary under Sec. 162.910(a).

    Direct data entry means the direct entry of data (for example, using 

dumb terminals or web browsers) that is immediately transmitted into a 

health plan's computer.

    Electronic media means the mode of electronic transmission. It 

includes the Internet (wide-open), Extranet (using Internet technology 

to link a business with information only accessible to collaborating 

parties), leased lines, dial-up lines, private networks, and those 

transmissions that are physically moved from one location to another 

using magnetic tape, disk, or compact disk media.

    Format refers to those data elements that provide or control the 

enveloping or hierarchical structure, or assist in identifying data 

content of, a transaction.

    HCPCS stands for the Health [Care Financing Administration] Common 

Procedure Coding System.

    Maintain or maintenance refers to activities necessary to support 

the use of a standard adopted by the Secretary, including technical 

corrections to an implementation specification, and enhancements or 

expansion of a code set. This term excludes the activities related to 

the adoption of a new standard or implementation specification, or 

modification to an adopted standard or implementation specification.

    Maximum defined data set means all of the required data elements for 

a particular standard based on a specific implementation specification.



[[Page 676]]



    Segment means a group of related data elements in a transaction.

    Standard transaction means a transaction that complies with the 

applicable standard adopted under this part.



Subparts B--H [Reserved]