Individual who electronically or manually selects and extracts information from a patient’s medical record from computer files or paper files. Coded diagnoses can be used in a facility to track morbidity and mortality, infectious disease, and index disease information for quality of care and utilisation review. Another use for extracted data is the submission of insurance claims.

Under the Medicare programme, incidents or practises that are not usually considered fraudulent but are inconsistent with accepted sound medical business or fiscal practises (e.g., billing for noncovered services, excessive charges, improper billing practises, billing Medicare beneficiaries at a higher rate than other patients, submitting bills to Medicare instead of to primary third-party payers, billing for medically unnecessary services, violating the Medicare particpation agreement, billing for medically unnecessary services, violating the Medicare particpation agreement and billing for medically unnecessary services.