IHS Business Practices and Office Management — Questions and Answers
Question 1: Under HIPAA's Privacy Rule, a hearing instrument specialist may share a patient's protected health information (PHI) without obtaining patient authorization in which of the following situations?
- When sharing records with the patient's employer at the employer's request
- When coordinating treatment with another healthcare provider involved in the patient's care (Correct answer)
- When a family member asks for the patient's audiogram results
- When posting a patient success story on the practice's social media
Correct answer: When coordinating treatment with another healthcare provider involved in the patient's care
HIPAA permits sharing PHI without patient authorization for treatment, payment, and healthcare operations (TPO). Coordinating care with another treating provider falls under 'treatment' and does not require a separate authorization. Sharing with employers, family members (without patient consent), or on social media all require explicit patient authorization.
Question 2: Which infection control practice is MOST important when handling hearing aids that have been worn by a patient?
- Autoclaving the devices between appointments
- Wiping devices with a dry cloth before inspection
- Using appropriate disinfectant wipes or UV sanitizers designed for hearing instruments (Correct answer)
- Placing used devices in a sealed bag for 24 hours before handling
Correct answer: Using appropriate disinfectant wipes or UV sanitizers designed for hearing instruments
Hearing instruments that have been worn should be cleaned and disinfected using products specifically designed for hearing aids (e.g., germicidal wipes or UV sanitizing units). Autoclaving would destroy electronic components. Simple dry wiping is insufficient. Standard precautions require proper disinfection to prevent cross-contamination between patients.
Question 3: A patient's hearing aid purchase is being submitted to their insurance under CPT coding. Which code range is most commonly associated with hearing aid-related services?
- CPT V codes (vision services)
- CPT V5000–V5999 series (hearing services) (Correct answer)
- CPT 92000–92999 (special otorhinolaryngologic services)
- ICD-10 codes only — CPT codes do not apply to hearing aids
Correct answer: CPT V5000–V5999 series (hearing services)
Hearing aid dispensing and related services are billed using CPT V-codes in the V5000–V5999 range (e.g., V5010 for assessment for hearing aid, V5014 for repair/modification). These are the standard procedure codes used for hearing instrument services when submitting claims to insurers.
Question 4: The Americans with Disabilities Act (ADA) requires hearing instrument dispensing offices to:
- Provide hearing aids free of charge to patients who cannot afford them
- Employ at least one audiologist alongside the hearing instrument specialist
- Provide effective communication accommodations and accessible facilities for patients with disabilities (Correct answer)
- Offer only digital hearing aids to comply with modern accessibility standards
Correct answer: Provide effective communication accommodations and accessible facilities for patients with disabilities
The ADA requires places of public accommodation — including hearing aid dispensing offices — to provide effective communication for patients with disabilities and to ensure physical accessibility. This includes things like written materials, captioning, or accessible entrances. It does not mandate free products or staffing requirements.
Question 5: Which of the following is the BEST practice for maintaining patient records in a hearing instrument dispensing practice?
- Storing paper records in an unlocked filing cabinet for easy staff access
- Keeping records only for one year after the patient's last visit
- Maintaining secure, confidential records for the period required by state law, typically 5–10 years (Correct answer)
- Deleting electronic records annually to comply with data minimization rules
Correct answer: Maintaining secure, confidential records for the period required by state law, typically 5–10 years
State laws vary but generally require patient records to be retained for a minimum of 5–10 years (longer for minors). Records must be stored securely to protect PHI under HIPAA. Premature destruction of records or unsecured storage violates both state regulations and federal HIPAA requirements.
Question 6: A patient requests a copy of their own audiogram and hearing aid records. Under HIPAA, the dispensing practice must:
- Deny the request if the records might confuse the patient
- Provide the records only if the patient's physician co-signs the request
- Provide the patient access to their records, typically within 30 days (Correct answer)
- Charge the patient a flat fee of $50 before releasing any records
Correct answer: Provide the patient access to their records, typically within 30 days
HIPAA's Privacy Rule grants patients the right to access their own medical records. The covered entity must provide access within 30 days (with a possible 30-day extension). While a reasonable cost-based fee for copying may be charged, access cannot be denied based on the practice's judgment about what the patient can understand, and no physician co-signature is required.
