AAHIM | Clinical Validation

Overview

Clinical validation is the process of validating each diagnosis or procedure documented within the health record, ensuring it is supported by clinical evidence in the medical record. Based on the False Claims Act of 1863, CMS does not permit providers to submit claims with codes for conditions that cannot be clinically validated based on authoritative and/or widely accepted diagnostic standards. On the other hand the Official Guidelines for Coding and Reporting give instructions that the assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis. This session will address these conflicting imperatives and propose solutions to this dilemma.

Learning Objectives:

• Define clinical validation
• Explain the distinction between coding regulations and CMS billing regulations and applicable statutes
• Articulate solutions to these conflicting imperatives

Date

Published Date
April 2022 

Speakers

Dr. Richard Pinson, MD, FACP, CDIP, CCS

Cynthia Tang, RHIA, CCS, CRC

Pricing

• AAHIM Member  – $40.00
• Non-Member  – $40.00
• Student  – $20.00

CE

# of CEs:
2.0 – Clinical Foundations
2.4 – Nursing CEUs

AHIMA

This educational offering has been approved for continuing education credit for use in fulfilling the continued education requirements of the American Health Information Management Association (AHIMA).

AAPC

CEUs are accepted from programs sponsored by AHIMA national offices and the state or regional AHIMA branches. One hour of instruction is worth one CEU.  A certificate of attendance or completion is necessary to show participation.

Instructions

Register

In order to access this course, you will need to click on the button labeled “Register for this Course“.

Already Purchased Course?

If you have already purchased this course, then you will need to sign in to access and then click on the session(s) listed under Course Content.

Access instructions for the course will be emailed to you within 2 business days following receipt of payment.

You will have 60 days to access the course after access has been granted.

How Do I Receive the CE?

You must click on the button labeled “Mark Complete” at the bottom of each course page before the CE will appear on the My Certificates page

FAQs

• Access instructions for the course will be emailed to you within 2 business days following receipt of payment.
  
  
• You will have 60 days to access the course. If your course has expired, and you need an extension, please contact us.
  
  
• You must click on the button labeled “Mark Complete” at the bottom of each course page before the CE will appear on the My Certificates page.

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