Certified Inpatient Coding (CIC) Practice Exam

Which types of information are included in protected health information (PHI)?

1. Only patient's present conditions

2. Patient's past and present conditions and payment for healthcare

3. Only demographic information

4. The patient's present and past conditions, payment for healthcare, and demographic information

The correct answer is: The patient's present and past conditions, payment for healthcare, and demographic information

Protected Health Information (PHI) encompasses a comprehensive range of data that identifies an individual and relates to their health status. This includes not only the patient’s present and past medical conditions but also information regarding their healthcare payment details and demographic data. Demographic information is crucial because it helps to identify the individual and may include details such as name, address, date of birth, and Social Security number. The inclusion of both past and present medical conditions acknowledges the ongoing nature of healthcare and the need for a complete picture of a patient’s medical history for effective treatment and billing purposes. Furthermore, details about payment for healthcare are critical for financial transactions and constitute part of the patient's health and treatment information. Thus, the correct answer captures the broad scope of what constitutes PHI, highlighting the interconnectedness of an individual’s health conditions, demographic details, and financial aspects related to their healthcare. This comprehensive definition reflects the intent of regulations such as HIPAA, which fundamentally aims to protect an individual's medical records and other personal health information from unauthorized access or disclosure.