Chapter 12: Coding And Clinical
Documentation Integrity Mangement
Questions And Answers With Verified
Solutions Already Passed!!!
Benchmarking - ANSWER✔✔The process of comparing performance with a
preestablished standard or performance of another facility or group.
CC/MCC Capture Rate - 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 - ANSWER✔✔A measure of the coding unit's or organization's
ability to comply with billing edits.
Clinical Documentation Integrity (CDI) - ANSWER✔✔Program that strives to
initiate concurrent and retrospective reviews of medical records to improve the
quality of provider documentation.
Coding Compliance Plan - 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 - 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) - 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 - 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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