Individual overseeing a facility’s or medical practice’s compliance program who plans, implements, and monitors the program with a staff trained to perform activities that comply with the Health Insurance Portability and Accountability Act (HIPAA) rules.
Tag: RAW
Compliance oversight officer
The approved person, having significant influence and acting in the capacity of director or senior manager, who is allocated the compliance oversight function. He or she must ensure that the firm acts in accordance with FSA rules. He or she needs unfettered access to all individuals and information in order to further the sound and prudent management of the firm.
Compliance plan
Auditing, monitoring, and staff training implemented to get rid of errors in coding, billing, and transmission of electronic claims for compliance with HIPAA guidelines.
Compliance program
A management plan adopted by a medical practice or facility that is composed of policies and procedures to accomplish uniformity, consistency, and conformity in medical recordkeeping that fulfills official HIPAA requirements. It fosters prevention of fraudulent activities by the development of internal controls.
Complication
Disease or condition arising during the course of, or as a result of, another disease, modifying medical care requirements; for diagnosis-related groups (DRGs), a condition that arises during the hospital stay that prolongs the length of stay by at least 1 day in approximately 75% of cases. Also known as substantial complication.
complications and comorbidities (CC)
Key factors in establishing a diagnosis-related group (DRG). See complication and comorbidity.
Component code
1. The portion of a service described before the semicolon (;) of a CPT comprehensive code, together with the portion of a service described by the indented (component) code. 2. Under the Correct Coding Initiative (CCI), a CCI file known as component edits lists pairs of codes considered an integral part of the main surgical service provided or a component of a more comprehensive procedure. When billing a Medicare case, a component code that follows a comprehensive code cannot be charged to Medicare if the comprehensive code is billed.
component code, column I
In the Correct Coding Initiative (CCI) edits, the code that follows the column I code, which cannot be billed when the more comprehensive code is billed.
Component coding
Standardizing method that allows a physician to list a code, regardless of specialty, that specifically identifies whether the procedural component, the radiological component, or both aspects of the service was provided.
Component Parts Clause
A Clause under an Aviation Hull policy which restricts the insurer’s liability in respect of a give component part to a stated proportion of the sum insured.