Chapter 25

3. Classification system used in the US for reporting of inpatient hospital procedures replaces ICD-9-CM Volume 3
4. Information Management Practitioners, term used to encompass both registered health information administrators and registered health information
6. Classification system that replaced ICD-9-CM, volume 1&2 October 1, 2015
9. Health Record, electronic health record system generally considered as the portal though which clinicans access a patient’s health record
11. Commission, organization that accredits and certifies health care organizations and other programs in the US
12. Improvement, process by which the quality of the care and services provided to patients within a health care facility is monitored and evaluated
14. Groups, (DRGs) system that categorizes into payment groups patients who are medically related with respect to diagnosis and treatment and statistically similar with regard to length of stay
16. professionals who are technical experts in health data collection, analysis, monitoring, maintenance, and reporting activities in accordance with established data quality principles

1. Facilities Accreditation Program, an accreditation program “authorized by the Centers of Medicare and Medicaid Services to survey”
2. Health Insurance Portability and Accountability Act of 1996 federal legislation passed, privacy, security, and establishment of standards health information
5. Patient Classifications, APC’s Classification system of patients based on the International Classification of Diseases, clinical modification of codes for diagnosis
7. Procedural Terminology, (CPT-4) listing of medical terms and codes for the uniform designation of diagnostic and therapeutic procedures
8. professionals who possess the expertise to develop, implement, and manage individual, aggregate, and public health care data un support of patient safety and privacy
10. Records, permanent or long-lasting documentation of all patient care information that applies to individual patients
13. system for Medicare patients by which the quality of the care and services provided to patients within a health care facility is monitored and evaluated
15. Classification system used in the US to report morbidity and mortality information until September 30, 2015