Coding and Data Quality (CDQ)

This site is a resource for coding and data quality issues. Here CHIA will continue to post articles and resources that address coding classification official guidelines, medical record documentation topics, payer guidelines, and data reporting. Use these resources as a means to more fully understand and improve the quality of medical coding, clinical documentation, and to help educate your medical staff and other healthcare colleagues on these issues.

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Coding and Data Quality Articles Solicited

CHIA accepts original, unpublished manuscripts about current issues and best practices in health information management. CHIA encourages members and other individuals to submit manuscripts for publication in the CHIA Journal and/or on this site. See CHIA Publication Guidelines for details.

Insights to Coding Data Quality - Featured Articles

All articles were published in the CHIA Journal.
FY 2015 inpatient prospective payment system grouper changes - October 2014
Medicare overpayment collection process - Information released - September 2014
Discharge disposition differences in Home Health Hospice, between OSHPD and Medicare - September 2014
OSHPD patient data regulations update – A move toward national standards - August 2014
OIG reports again on post acute care transfer rule - August 2014
Spinal Surgery Webinar question on Kyphoplasty versus Vertebroplasty - April 2014
Office of Inspector General (OIG) Semi-annual Report - April 2014
OSHPD discharge disposition codes for home health-based hospice - February 2014
Spinal Surgery Webinar question on vertebral corpectomy procedures - February 2014
Review of the Medicare Outpatient Prospective Payment System Final Rule for 2014 - February 2014
CMS releases OPPS Final Rule - December 2013/January 2014
Reliability of documentation – What is a coder to do? - November 2013
Medicare overpayments to hospitals for mechanical ventilation greater than 96 hours - November 2013
CMS issues new admission and medical review guidance - November 2013
2014 CPT code update - November 2013
OIG recommends transfer policy for hospice providers - October 2013
IPPS proposal FY2015 The Hospital-Acquired Condition Reduction Program - October 2013
Planned readmission discharge status codes - September 2013
D-day for coders – October 1, 2014 - September 2013
AHA Coding Clinic guidance: Code number in lieu of a diagnosis - September 2013
More Coding Articles

Coding Classification Authorities

Specific organizations are recognized as the national authorities on coding classifications and advice. Classification changes and associated guideline development are the responsibility of the various medical code set maintenance organizations. Therefore, neither AHIMA nor CHIA may issue coding guidelines independently.

The ICD-9-CM and ICD-10-CM/PCS classification systems are maintained by the National Center for Health Statistics (NCHS) and the Centers for Medicare & Medicaid Services (CMS).

The Current Procedural Terminology (CPT) code set is maintained by the American Medical Association through the CPT Editorial Panel.

The Healthcare Common Procedure Coding System (HCPCS) is under the authority of CMS.

The American Hospital Association’s Central Office serves as the official U.S. Clearinghouse on medical coding for the proper use of the ICD-9-CM systems and Level I HCPCS (CPT-4 codes) for hospital providers and certain Level II HCPCS codes for hospitals, physicians and other health professionals.

The ICD-9-CM coding guidelines are clarified through unanimous agreement by the Cooperating Parties of the ICD-9-CM Coding Clinic. The Cooperating Parties are NCHS, CMS, AHIMA and the American Hospital Association (AHA). Therefore, neither AHIMA nor CHIA may issue coding guidelines independently. AHIMA and the other Cooperating Parties can only refer coders seeking official ICD-9-CM coding advice to the AHA.