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Evaluation of coding data quality of the HCUP National Inpatient Sample. HCUP全国住院患者样本编码数据质量评价。
Topics in health information management Pub Date : 2000-11-01
C L Berthelsen
{"title":"Evaluation of coding data quality of the HCUP National Inpatient Sample.","authors":"C L Berthelsen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Quality ICD-9-CM coding depends on the selection of the appropriate diagnosis codes and the proper sequencing of the codes. A simple, diagnosis code-sequencing error was selected to evaluate the quality of diagnosis coding within the National Inpatient Sample of the Healthcare Costs and Utilization Project. The source of coding variation originates at the hospital level. Coding error rates were found to vary widely among states, hospitals within states, geographic location, and hospital characteristics. Coding errors were significantly different among patient demographic groups and whether the state used billing versus abstract data.</p>","PeriodicalId":79756,"journal":{"name":"Topics in health information management","volume":"21 2","pages":"10-23"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21963377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Challenges of coding ambulance service for reimbursement. 救护车服务编码报销的挑战。
Topics in health information management Pub Date : 2000-11-01
H Schmitz, H Riggs
{"title":"Challenges of coding ambulance service for reimbursement.","authors":"H Schmitz,&nbsp;H Riggs","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Emergency medical transportation services have some different characteristics than other patient services that make billing for the services more difficult than for other providers. Payers have been less than systematic in their definition of medical necessity, a criterion that is required in order to justify reimbursement. As a result, documentation of an ambulance trip and appropriate coding of the activities carried out during the course of the trip are key elements in determining whether or not the service will be reimbursed. This article examines the many dilemmas associated with this issue.</p>","PeriodicalId":79756,"journal":{"name":"Topics in health information management","volume":"21 2","pages":"34-40"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21963380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Premillennial and postmillennial coding. 前千禧年和后千禧年的编码。
Topics in health information management Pub Date : 2000-11-01
J Morgan
{"title":"Premillennial and postmillennial coding.","authors":"J Morgan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79756,"journal":{"name":"Topics in health information management","volume":"21 2","pages":"81-4"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21965391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multilevel reviews for coding accuracy. 多层审查编码的准确性。
Topics in health information management Pub Date : 2000-11-01
S Stavely
{"title":"Multilevel reviews for coding accuracy.","authors":"S Stavely","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>If coders, case managers, diagnosis-related group (DRG) coordinators, and physicians work cooperatively, then documentation and coding accuracy can be greatly improved. A five-step process is proving effective toward compliance and appropriate reimbursement in a large acute care setting.</p>","PeriodicalId":79756,"journal":{"name":"Topics in health information management","volume":"21 2","pages":"30-3"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21963379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical vocabularies and terminologies: impact on the future of health information management. 临床词汇和术语:对未来健康信息管理的影响。
Topics in health information management Pub Date : 2000-11-01
S H Fenton
{"title":"Clinical vocabularies and terminologies: impact on the future of health information management.","authors":"S H Fenton","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As standardized clinical vocabularies and terminologies are being developed, Health Information Management (HIM) practitioners must increase their knowledge of nomenclature and coding systems beyond the traditional ICD-9-CM and CPT. The limited scope of these classifications prevents them from serving as the standard vocabulary for the computer-based patient record. The American Health Information Management Association (AHIMA) Coding Futures Task Force provided insights into the knowledge and skills that HIM professionals will need as clinical vocabularies and terminologies become more integrated into health care systems. Certain characteristics are important in a clinical vocabulary and several clinical vocabularies are in use today.</p>","PeriodicalId":79756,"journal":{"name":"Topics in health information management","volume":"21 2","pages":"74-80"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21965390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evolution of the uses of ICD-9-CM coding: Medicare risk adjustment methodology for managed care plans. ICD-9-CM编码使用的演变:管理式医疗计划的医疗保险风险调整方法。
Topics in health information management Pub Date : 2000-11-01
L Tully, V Rulon
{"title":"Evolution of the uses of ICD-9-CM coding: Medicare risk adjustment methodology for managed care plans.","authors":"L Tully,&nbsp;V Rulon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The health information management (HIM) profession is expanding to new sites and perspectives. The implementation of Medicare managed care has brought changes not only by emphasis on management of the individual's medical care and the cost of that care, but also by creating new uses for coded data. This article examines the evolution of risk adjustment methods in Medicare Managed Care. The current choice for risk adjustment is the Principal Inpatient Diagnostic Cost Groups (PIP-DCG). This article explains the health plan's submission of encounter data and how HIM can play a valuable role in data capture and improvement in data quality and reimbursement.</p>","PeriodicalId":79756,"journal":{"name":"Topics in health information management","volume":"21 2","pages":"62-7"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21963383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Case study: clinical documentation improvement program supports coding accuracy. 案例研究:临床文件改进程序支持编码准确性。
Topics in health information management Pub Date : 2000-11-01
J T Danzi, B Masencup, M A Brucker, C Dixon-Lee
{"title":"Case study: clinical documentation improvement program supports coding accuracy.","authors":"J T Danzi,&nbsp;B Masencup,&nbsp;M A Brucker,&nbsp;C Dixon-Lee","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Developing a comprehensive inpatient clinical documentation and coding improvement program that demonstrates successful outcomes and proves to be sustainable by the health care organization is a difficult process but significant in maintaining accurate coding and reimbursement under the Medicare system. This case study of one health care organization that undertook just such a comprehensive program, chronicles the steps involved, the categories of health care professionals necessary to support ongoing communication and education, and the need for physician partnerships to sustain the program and achieve results. The program had a positive impact with a net increase in reimbursement attributed directly to the case reviews and point of service clinical education. Creating a new position of Coding/Documentation Specialist, working at the point of care as a regulatory interpreter and coding expert, was found to be key to cementing the successful team approach to documentation quality.</p>","PeriodicalId":79756,"journal":{"name":"Topics in health information management","volume":"21 2","pages":"24-9"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21963378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Organizational status of quality assurance and end-user perceptions of information technology for information management. 质量保证的组织状况和最终用户对信息管理的信息技术的看法。
Topics in health information management Pub Date : 2000-08-01
P C Pendharkar, J A Rodger, D J Paper, L B Burky
{"title":"Organizational status of quality assurance and end-user perceptions of information technology for information management.","authors":"P C Pendharkar,&nbsp;J A Rodger,&nbsp;D J Paper,&nbsp;L B Burky","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article investigates the relationship between quality assurance (QA) and perceptions of the importance of information technology (IT) for information management in the health care industry. This issue is important because effective information management is recognized as a necessary condition for quality management. The unit of analysis of the article is the health care functional department. Data from 34 health care departments were collected and used for the analysis. Four specific hypotheses were proposed and tested. Our results suggest that end-user perceptions of the importance of IT for information management depends on formalization of QA, perceived importance of QA, time since QA was embraced, and number of people in the QA function.</p>","PeriodicalId":79756,"journal":{"name":"Topics in health information management","volume":"21 1","pages":"35-44"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21842611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cancer surveillance using data warehousing, data mining, and decision support systems. 使用数据仓库、数据挖掘和决策支持系统的癌症监测。
Topics in health information management Pub Date : 2000-08-01
G A Forgionne, A Gangopadhyay, M Adya
{"title":"Cancer surveillance using data warehousing, data mining, and decision support systems.","authors":"G A Forgionne,&nbsp;A Gangopadhyay,&nbsp;M Adya","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article discusses how data warehousing, data mining, and decision support systems can reduce the national cancer burden or the oral complications of cancer therapies, especially as related to oral and pharyngeal cancers. An information system is presented that will deliver the necessary information technology to clinical, administrative, and policy researchers and analysts in an effective and efficient manner. The system will deliver the technology and knowledge that users need to readily: (1) organize relevant claims data, (2) detect cancer patterns in general and special populations, (3) formulate models that explain the patterns, and (4) evaluate the efficacy of specified treatments and interventions with the formulations. Such a system can be developed through a proven adaptive design strategy, and the implemented system can be tested on State of Maryland Medicaid data (which includes women, minorities, and children).</p>","PeriodicalId":79756,"journal":{"name":"Topics in health information management","volume":"21 1","pages":"21-34"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21842610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Managing the learning and work of new information technology users. 管理新信息技术用户的学习和工作。
Topics in health information management Pub Date : 2000-08-01
B Minard
{"title":"Managing the learning and work of new information technology users.","authors":"B Minard","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The information technology revolution has transformed work from modest-paced serial processes to complex, fast-paced networked ones that depend not only on the technology but also on skilled and effective users of the technology. This evolution has woven a complex quilt of interdependencies among new information technologies, new users of those technologies, new skills required, new information management policies and procedures, and new opportunities. We must impose a new structure for managing the learning and work of new users, their tolerance of complexity and continuous learning, value-added usability, minimization of human error, and new support services for deployment, administration, and help.</p>","PeriodicalId":79756,"journal":{"name":"Topics in health information management","volume":"21 1","pages":"79-83"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21841587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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