DSMO Response Categories

A. Modifications necessary to permit compliance with the standard/law.
    According to DHHS, necessary items include
    1. Something in the adopted standard or implementation specification conflicts with the regulation.
    2. A non-existent data element or code set is required by the standard. (removal of data content that is not supported by the healthcare industry any longer)
    3. A data element or code set that is critical to the industry's business process has been left out.
    4. There is a conflict among different adopted standards
    5. There is an internal conflict within a standard (implementation guide).

B. Modifications.
Classified as additions or deletions of data elements, internal code list values, segments, loops; changes in usage of segments, data elements, internal code list values; changes in usage notes;  changes in repeat counts; changes in formatting notes or explanatory language that do not fall into Category A.

C. Maintenance.
Classified as items that do not impact the implementation of the transaction.  Items classified as Maintenance will require no further DSMO actions.  Items are to follow the SDO process.

D. No Change.
Classified as items that the implementation guides do meet the needs requested, or did go through the consensus building process originally to meet need. May request follow up by the submitter for further action.

E. DHHS Policy.
Classified as items that require follow up by the Department of Health and Human Services in regards to the Final Rule.

F. Withdrawn by Submitter.
Classified as items that have been removed from Change Request System consideration.

G. Appeal.
Classified as items where the DSMOs did not reach consensus on response and will follow the appeal process.

H. Industry Comment Request Process.
Classified as items that require comments from the industry to determine consensus.

I. Recommendation for adoption of new/modified HIPAA standard.
Classified as items that result in the recommendation to the National Committee on Vital and Health Statistics for the adoption of a new/modified HIPAA standard. Examples might include a request for a new transaction, or a new version or release of an already-named standard for a given transaction(s).

J. Out of DSMO Scope.
Classified as items that are not in the scope of the DSMO. An example is change requests for modifications to transactions not named in HIPAA.

Appeal Categories
Appeal Outcome Available Soon
Appeal Withdrawn
Appeal Upheld
Appeal Denied
Appeal Remanded
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