Match the term with its description.

Question

A. software tools that incorporate the text and logic of coding systems in an automated form
B. software programs that use branching logic to arrive at the most accurate DRG
C. persons who are responsible for the development, maintenance, and management of vocabularies and classification systems
D. automated programs that seek the highest paying DRG based on the codes assigned and in compliance with prevailing regulations
E. software programs that can read and interpret digital text from online documents and automatically assign appropriate codes
F. practice of selecting a code and submitting a bill for a higher level of reimbursement than actually rendered in order to receive a higher reimbursement
G. the efforts to establish a culture that promotes prevention, detection, and resolution of instances of conduct that do not conform to applicable local, state, and federal laws and regulations
H. ensures the establishment of effective internal controls that detect, correct, and prevent coding errors and promote adherence to the applicable local, state, and federal laws and regulations and the program requirements of federal, state, and private health plans
I. false misrepresentation or intentional deception of fact that is a departure from reasonable use and could result in unauthorized payment

Answer 1

A. encoders
B. groupers
C. nosologists
D. optimizing programs
E. natural language processing encoding systems
F. upcoding
G. compliance
H. coding compliance program
I. health care fraud and abuse