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CHIA accepts original, unpublished manuscripts about current issues and best practices in health information management.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 written for the CHIA Journal.
* Some articles are only available online on this resource page.

FY 2016 IPPS - May 2016 *
2016 CPT Update - March/April 2016
OIG Released - New Guidance for Health Governing Boards - February 2016 *
September 2015 ICD-10-CM Coordination and Maintenance Meeting - December 2015 *
The Office of Inspector General Work Plan: A Useful Compliance Tool - September/October 2015
RAC Update: Program Improvements delayed until 2016 - September/October 2015
Chronic kidney disease - May 2015
Cardiac arrest versus acute respiratory failure - How would you code it? - May 2015
ICD-9-CM and 2015 ICD-10-CM Present of Admission (POA) list of exempt codes - April 2015
September 2014 ICD-10-CM Coordination and Maintenance Committee - March 2015
2015 CPT changes – An overview - February 2015
Mechanical ventilation coding an Office of Inspector General target - December 2014/January 2015
ICD-9 and ICD-10 dual coding: Key to coding staff preparation - December 2014/January 2015
New modifiers for distinct procedural services - November 2014
Medicare no longer pays for some outpatient lab tests - November 2014
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

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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.