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Chapter 12: Coding and Clinical Documentation Integrity Management verified/passed
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Chapter 12: Coding and Clinical Documentation Integrity Management verified/passed
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Chapter 12: Coding and ClinicalDocumentation Integrity Management
Benchmarking - correct answer ✔✔The process of comparing performance with a preestablished
standard or performance of another facility or group.
CC/MCC Capture Rate - correct answer ✔✔Using the MS-DRG system, it is the percent of admission
within an MS-DRG family assigned to an MS-DRG with CC, MCC, or both.
Clean Claim Rate - correct answer ✔✔A measure of the coding unit's or organization's ability to comply
with billing edits.
Clinical Documentation Integrity (CDI) - correct answer ✔✔Program that strives to initiate concurrent
and retrospective reviews of medical records to improve the quality of provider documentation.
Coding Compliance Plan - correct answer ✔✔A component of a health information management
compliance plan or a corporate compliance plan that focuses on the unique regulations and guidelines
with which coding professionals must comply.
Coding Management - correct answer ✔✔Management unit responsible for organizing the coding
process so healthcare data can be transformed into meaningful information required in claims
processing.
Computer-assisted coding (CAC) - correct answer ✔✔Coding tool which uses a process of extracting and
translating free-text data and electronic health record data into medical codes for billing and coding
purposes.
Denial Rate - correct answer ✔✔A measure of how well a facility or practice complies with billing rules
and regulations for all payers. Specific to coding management, it is a metric used to determine if the
coding unit complies with coding requirements.
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