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The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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Use and Disclosure of PHI 

This section contains all of the situations in which a covered entity is allowed or disallowed to use or disclose protected health information.

Treatment, Payment, Health Care Operations

    • Permitted uses and disclosures
    • Consent for uses and disclosures permitted
    • Treatment, payment, or health care operations
    • Healthcare operations

    When Authorization is Required

      • Psychotherapy notes
      • Marketing
      • Sale of protected health information

    Requirements for a Valid Authorization

      • Valid Authorizations
      • Defective Authorizations
      • Compound Authorizations
      • Prohibition on conditioning of authorizations
      • Revocation of Authorizations
      • Core elements of a valid authorization
      • Required statements
      • Documentation

    Patient has the Opportunity to Agree or Object

      • Facility Directories
      • Involvement in the Individual's Care and Notification Purposes

      Authorization or Opportunity to Agree or Object is Not Required

        • Uses and Disclosures for Public Health Activities
        • Disclosures about Victims of Abuse, Neglect or Domestic Violence
        • Uses and Disclosures for Health Oversight Activities
        • Disclosures for Judicial and Administrative Proceedings
        • Disclosures for Law Enforcement Purposes
        • Uses and Disclosures about Decedents
        • Uses and disclosures for cadaveric organ, eye or tissue donation purposes
        • Uses and Disclosures for Research Purposes
        • Uses and Disclosures to Avert a Serious Threat to Health or Safety
        • Uses and Disclosures for Specialized Government Functions
        • Disclosures for Workers' Compensation

      De-Identification of Protected Health Information

        • De-identification
        • Re-identification
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