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The basic task of a clinical coder is to classify medical and health care concepts using a standardised classification. Inpatient, mortality events, outpatient episodes, general practitioner visits and population health studies can all be coded. Clinical coding has three key phases: a) abstraction; b) assignment; and c) review. [5]
Such coding is necessary for Medicare, Medicaid, and other health insurance programs to ensure that insurance claims are processed in an orderly and consistent manner. Initially, use of the codes was voluntary, but with the implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) use of the HCPCS for ...
The CCC provides a unique framework and coding structure. Used for documenting the plan of care; following the nursing process in all health care settings. [1] The Clinical Care Classification (CCC), previously the Home Health Care Classification (HHCC), was originally created to document nursing care in home health and ambulatory care settings ...
Types of coding systems specific to health care include: Diagnostic codes. Are used to determine diseases, disorders, and symptoms; Can be used to measure morbidity and mortality; Examples: ICD-9-CM, ICD-10, ICD-11 [1] Procedural codes. They are numbers or alphanumeric codes used to identify specific health interventions taken by medical ...
The PMAG is composed of performance measurement experts representing the Agency for Healthcare Research and Quality (AHRQ), the American Medical Association (AMA), the Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance (NCQA ...
APCs or Ambulatory Payment Classifications are the United States government's method of paying for facility outpatient services for the Medicare (United States) program. A part of the Federal Balanced Budget Act of 1997 made the Centers for Medicare and Medicaid Services create a new Medicare "Outpatient Prospective Payment System" (OPPS) for hospital outpatient services -analogous to the ...