Cdip Exam Prep Study Guide 2023

OIG - Office of Inspector General- established by the Dept. of Labor by the Inspector General Act of 1978 to identify fraud and abuse of Medicare part A and part B programs MAC - Medicare Administrative Contractor - used by the OIG to process claims for services rendered Criteria for high quality documemtation - 1. Legible 2. Reliable 3. Precise 4. Complete 5. Consistent 6. Clear 7. Timely EBM - Evidence Based Medicine - the best scientific data a available for clinical documentation Two part theory for high quality clinical documentation is derived from what - Legal/regulatory sources and peer reviewed research Four standards used in EBM - 1. Design 2. Terminology 3. Performance 4. Procedural DHHS - Department of Health and Human services ARRA - American Recovery and Reinvestment Act of 2009 provides specific guidance established as part of the meaningful use incentive program Meaningful use requirements - Provider must maintain an up to date problem list of current and active diagnoses for 80% of patients and 80% of all patients have to have at least one coded problem as opposed to their entire problem list coded IPPS - Hospital Inpatient Prospective Payment System. Reimbursement now being driven by codes assigned to the patient stay with the inception of IPPS in 1982 House Staff - Interns, residents and fellows - physicians in training CMS - Centers for Medicare and Medicaid Services NCHS - National Center for Health Statistics