I.B. Subdomain: Healthcare Information Healthcare Information Requirements and Standards Requirements and Standards Standards and regulations for documentation (such as 1. Develop organization-wide health record Joint Commission, CARF, COP) (Evaluating, 5) documentation guidelines. Health information standards (such as HIPAA, ANSI, HL-7, 2. Maintain organizational compliance with UMLS, ASTM ) (Applying, 3) regulations and standards. Patient Identity Management Policies (MPI) (Applying, 3) 3. Ensure organizational survey readiness for accreditation, licensing and/or certification processes. 4. Design and implement clinical documentation initiatives. I.C. Subdomain: Clinical Classification Clinical Classification Systems Systems Healthcare taxonomies, clinical vocabularies, 1. Select electronic applications for clinical nomenclatures (such as ICD-9-CM, ICD-10-CM/PCS, CPT, classification and coding. SNOMED-CT, DSM-IV, LOINC) (Understanding, 2) 2. Implement and manage applications and Severity of illness systems (Analyzing, 4) processes for clinical classification and Data integrity, coding audits (Analyzing, 4) coding. CCI, electronic billing, X12N, 5010 (Applying, 3) 3. Maintain processes, policies, and procedures to ensure the accuracy of coded data. I.D. Subdomain: Reimbursement Reimbursement Methodologies Methodologies Clinical data and reimbursement management 1. Manage the use of clinical data required in (Evaluating, 5) prospective payment systems (PPS) in Compliance strategies and reporting (Analyzing, 4) healthcare delivery. Chargemaster management (Analyzing, 4) 2. Manage the use of clinical data required in other reimbursement systems in healthcare Case mix management (Analyzing, 4) delivery.
I.B. Subdomain: Healthcare Information Requirements and Standards 1. Develop organization-wide health record documentation guidelines. 2. Maintain organizational compliance with regulations and standards. 3. Ensure organizational survey readiness for accreditation, licensing and/or certification processes. 4. Design and implement clinical documentation initiatives. Healthcare Information Requirements and Standards Standards and regulations for documentation (such as Joint Commission, CARF, COP) (Evaluating, 5) Health information standards (such as HIPAA, ANSI, HL-7, UMLS, ASTM ) (Applying, 3) Patient Identity Management Policies (MPI) (Applying, 3) I.C. Subdomain: Clinical Classification Systems 1. Select electronic applications for clinical classification and coding. 2. Implement and manage applications and processes for clinical classification and coding. 3. Maintain processes, policies, and procedures to ensure the accuracy of coded data. Clinical Classification Systems Healthcare taxonomies, clinical vocabularies, nomenclatures (such as ICD-9-CM, ICD-10-CM/PCS, CPT, SNOMED-CT, DSM-IV, LOINC) (Understanding, 2) Severity of illness systems (Analyzing, 4) Data integrity, coding audits (Analyzing, 4) CCI, electronic billing, X12N, 5010 (Applying, 3) I.D. Subdomain: Reimbursement Methodologies 1. Manage the use of clinical data required in prospective payment systems (PPS) in healthcare delivery. 2. Manage the use of clinical data required in other reimbursement systems in healthcare delivery. Reimbursement Methodologies Clinical data and reimbursement management (Evaluating, 5) Compliance strategies and reporting (Analyzing, 4) Chargemaster management (Analyzing, 4) Case mix management (Analyzing, 4)
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