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How do the Healthcare (HIPAA) lexicons work?

The Healthcare lexicons/filters are designed to identify PHI (Protect Health Information) as defined by the Health Insurance Portability and Accountability Act (HIPAA). The Healthcare lexicons are a set of two lexicon files (Health Identifiers and Health Terms) that work together to identify PHI. The lexicons locate PHI by scanning for identifying information, combined with health terms or claims information. This provides the highest level of confidence that context is actually PHI. An example of this would be a document containing a patient’s date of service and a diagnosis. The date of service would constitute an identifier, and the diagnosis would constitute health information.
 
The Health Identifiers Lexicon scans for a variety of terms, including:

  • Member Numbers
  • Medical Savings Account numbers
  • Medical Record Numbers
  • Subscriber Numbers
  • Patient ID numbers

The above are only considered "identifiers" when they are found in close proximity to a number that is at least 5 digits long.

  • Admit dates
  • Dates of Birth
  • Dates of Death
  • Dates of Discharge
  • Dates of Service

The above are only considered "identifiers" when they are found in close proximity to a date.
 
The Health Terms Lexicon scans for a variety of terms, including:

  • Diseases
  • Chemicals, Drugs, and Analytic, Diagnostic or Therapeutic Techniques
  • Substance Use or Abuse
  • Mental Health Terms
  • Medical Records Information
  • Insurance Information
  • Medications
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  1. Carlos Rios

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