HIPAA Consult

June 2, 2006

Answers to your questions about...notice of privacy practice;listing of diagnosis codes; psychotherapy notes

Notice of privacy practices

Q. What are my obligations under HIPAA when it comes to distributing our office's notice of privacy practices?

If, in looking over your records, you find nothing to indicate that an established patient ever received your notice of privacy practices, give that patient the notice and try to obtain the patient's written acknowledgment. A word of caution: If you continue to treat a patient who hasn't received an NPP, that patient has the right to file a complaint against you with the Office for Civil Rights, US Department of Health and Human Services.

Listing diagnosis codes

Q. Does HIPAA permit diagnosis codes to be on patient statements?

A. Yes. It permits this information on patient statements, just as it permits a patient's name, address, date of service, and other operationally appropriate data. That said, if you're uncertain who else besides the patient might have access to her statement, exercise reasonable caution. For instance, if you send the statement via regular mail, label the envelope "Confidential." If you fax it, alert the patient so that she can retrieve it.

Psychotherapy notes

Q. I received a medical release form that authorizes me to disclosure "psychiatric information" about a patient I've been treating for depression. Does this release require me to release her "psychotherapy notes"?

A. No. The term "psychiatric information" refers to any data in the medical record that has to do with a patient's psychiatric diagnosis, treatment, and so on. The term "psychotherapy notes," on the other hand, has a distinct meaning under HIPAA. It refers to notes that have been made by a psychiatrist or therapist that are retained separate and apart from the medical record. For this reason, just because you've been authorized to disclose your patient's psychiatric information doesn't mean you can also disclose psychotherapy notes in your possession that pertain to her.

Margaret M. Davino (mdavino@kbrny.com
) is a healthcare attorney with Kaufman Borgeest & Ryan, in New York City.

This department answers common HIPAA-related questions. It isn't intended to provide specific legal advice. Please submit questions via e-mail to mehipaa@advanstar.com
, or by regular mail to Medical Economics, 5 Paragon Drive, Montvale, NJ 07645, ATTN: HIPAA CONSULT. If we select your query, we'll address it in an upcoming issue. Your name will not be used.