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Clinical documentation improvement (CDI), also known as "clinical documentation integrity", is the best practices, processes, technology, people, and joint effort between providers and billers that advocates the completeness, precision, and validity of provider documentation inherent to transaction code sets (e.g. ICD-10-CM, ICD-10-PCS, CPT, HCPCS) sanctioned by the Health Insurance ...
AAPC provides training, certification, [9] and other services to individuals and organizations across medical coding, medical billing, auditing, compliance, and practice management. These services include networking events such as medical coding seminars and conferences. [10]
Healthcare Facilities Accreditation Program (HFAP) Healthcare Quality Association on Accreditation (HQAA) Institute for Medical Quality (IMQ) Joint Commission (TJC) National Committee for Quality Assurance (NCQA) National Dialysis Accreditation Commission (NDAC) [6] The Compliance Team, "Exemplary Provider Programs"
Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.
Applications range from coding rule validation, to automatic generation of testcases, to the proof of absence of run-time errors or generation of counterexamples, and to the specification of code matchers and rewriters based both syntactic and semantic conditions. Supports compliance standards (MISRA, Embedded C Coding Standard and others ...
The National Correct Coding Initiative (NCCI) is a Centers for Medicare & Medicaid Services (CMS) program designed to prevent improper payment of procedures that should not be submitted together. There are two categories of edits:
Early ISVV application (as known today) dates back to the early 1970s when the U.S. Army sponsored the first significant program related to IV&V for the Safeguard Anti-Ballistic Missile System. [6] Another example is NASA's IV&V Program, which was established in 1993. [7] By the end of the 1970s IV&V was rapidly becoming popular.
Software quality assurance (SQA) is a means and practice of monitoring all software engineering processes, methods, and work products to ensure compliance against defined standards. [1] It may include ensuring conformance to standards or models, such as ISO/IEC 9126 (now superseded by ISO 25010), SPICE or CMMI .