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Putting the ICD-10-CM/PCS GEMs into Practice (2016 update) - Retired

Author: Archer, Anita; Campbell, Angela; D'Amato, Cheryl; McLeod, Melissa; Rugg, Donna

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: January 2016


Editor's Note: This Practice Brief supersedes the May 2013 and March 2010 Practice Briefs titled "Putting the ICD-10-CM/PCS GEMs into Practice."


Mappings between ICD-9-CM and ICD-10-CM/PCS will play a critical role in the successful utilization of ICD-10-CM/PCS. The Centers for Me....

Implementation and Management of Patient Portals

Author: Baldwin, Kevin; Burton, Benjamin W; Cothran, Carey L.; DeMasters, Dana; Grady, Reginald; Halpert, Aviva M.; Hofman, Judi; Kadlec, Lesley; O'Dell, Rosann M; Pearson, Sandra; Deanna, Peterson; Rode, Dan; Rose, Angela Dinh; Schmidt, Peg

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: April 2015


The advancement of technology has changed the practice of medicine. It has evolved the physician-patient relationship from solely a face-to-face interaction into real-time online encounters, from e-mails to virtual appointments. Patient portals represent such a technological advancement, leadi....

Evolving Roles in Clinical Documentation Improvement: Physician Practice Opportunities

Author: Barnette, Erin; Endicott, Melanie; Ericson, Cheryl E; Wieczorek, Michelle M.

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: May 2017


In order to effectively discuss clinical documentation improvement (CDI) opportunities in physician practices, it is important to first understand the drivers and goals of a physician practice CDI program. Historically, diagnosis codes have had little impact in regard to physician practice paym....

Clinical Documentation Guidance for ICD-10-CM/PCS - Retired

Author: Bielby, Judy A; Comfort, Angie; Reed, Andretta; Wiedemann, Lou Ann

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: July 2014


Organizations were well on their way to an October 1, 2014 implementation of ICD-10-CM/PCS when Congress passed H.R. 4302, the Protecting Access to Medicare Act of 2014. This bill contained a section stating that the Department of Health and Human Services (HHS) could not adopt the new code set....

Management Practices for the Release of Information

Author: Bock, Linda J.; Demster, Barbara; Dinh, Angela K.; Gorton, Elisa R.; Lantis, James R. Jr.

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: November 2008


Exchange of health information is an essential function to the provision of high-quality and cost-effective healthcare. The information should be complete and timely for its intended purpose. While this sounds straightforward, often it is not an easy task in the complex medical and legal envir....

Measuring the Value of the Clinical Documentation Improvement Practitioner (CDIP) Credential - Retired

Author: Burgess, Sheila; Cooper, Sharon; Endicott, Melanie; Wallace, Susan; Wiedemann, Lou Ann

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: January 2015


This Practice Brief has been updated. See the latest version here. This version is made available for historical purposes only.

The role of the clinical documentation improvement (CDI) professional is ever-changing. When CDI programs first began in the late 1990s, the focus was almost....

Understanding Publicly Available Healthcare Data (2016) - Retired

Author: Buttner, Patty; Houser, Shannon H.; Flanigan, Jill; Mikaelian, Raymound; Ryznar, Barbara; Smith, Clarice Pittillo

Source: AHIMA practice brief

Publication Date: June 2016


This update supersedes the September 2013 practice brief, Understanding Publicly Available Healthcare Data, which replaced the January 2010 practice brief with the same title.


Healthcare organizations increasingly collect and utilize data for internal and external reporting on pa....

Beyond the Basics for Health Informatics Professionals - Retired

Author: Campbell, Angela; Houser, Shannon H.; Paulson, Dawn; Ryznar, Barbara; Smith, Clarice Pittillo; Woebkenberg, Jami; Hernandez, Sandra MSMIS, RHIA, CPHI, CCS, CHC; Pirie-St. Pierre, Mari RHIA, CPHI; Plimpton, Julie MSHI, RHIA, CPHI

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: September 2018





Editor’s Note: This Practice Brief supersedes the September 2014 Practice Brief “Defining the Basics of Health Informatics for HIM Professionals.”


Data, data everywhere! We are living in the age of “Big Data” and healthcare informat....

Tips for Breaking into the Health Information Management Industry - Retired

Author: Camp, Michelle; Comfort, Angie; Endicott, Melanie; Howard, Artis; Kozee, Renee; Munive, Roberta; Novelli, Staci

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: November 2014


Whether it is a first job or a career change, finding that first health information management (HIM) job following graduation is one of the biggest challenges that new graduates face. While some may find that breaking into the HIM industry takes time and persistence, it is a career choice that....

Provider’s Condensed Resource for Revenue Cycle, Coding Tools, and More

Author: Clack, Crystal; Freeman, Rae; Lewis, Laquette

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: January 2017


A cyclone of regulatory requirements for providers has officially touched down in the United States. The Affordable Care Act (ACA), Medicare Access and CHIP Reauthorization Act (MACRA), patient-centered medical home (PCMH), and value-based purchasing (VBP) initiatives are contributing to dramat....

Best Practices for Data Analytics Reporting Lifecycles: Quality in Report Building and Data Validation

Author: Clack, Lesley; Houser, Shannon H.; Kadlec, Lesley; Mikaelian, Raymound; Wendicke, Annemarie; Cain, Jeannine MSHI, RHIA, CPHI; Spears, Amanda MA, CHDA

Source: Journal of AHIMA | AHIMA practice brief

Publication Date: October 2018






While the importance of data quality in providing high-quality clinical care in today’s healthcare setting is typically well understood, the quality of data for report building and validation activities is often not well articulated—and potential data quality....

Guidelines for Achieving a Compliant ICD-10-PCS Query

Author: Combs, Tammy; DeVault, Kathryn; Easterling, Sharon; Endicott, Melanie; Isom, Crystal; Lojewski, Tedi; Simmons, Cortnie R.; Wolf, Beth

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: June 2016



Editor’s Note. This Practice Brief has been updated. See the latest version at Guidelines for Achieving a Compliant ICD-10-PCS Query
. This version is made available for historical purposes only.




The complex and highly specific nature of ICD-10-PCS has changed....

Impact of Physician Engagement on Clinical Documentation Improvement Programs (AHIMA Practice Brief)

Author: Combs, Tammy; Endicott, Melanie

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: July 2017


Physician engagement seems to be the buzzword in healthcare these days. Hospital administrators charged with various clinical improvement initiatives have come to realize that physician engagement is an essential element of success. While physician engagement in clinical documentation improveme....

Data Quality Management Model (2015 Update) - Retired

Author: Davoudi, Sion; Dooling, Julie A; Glondys, Barbara; Jones, Theresa D.; Kadlec, Lesley; Overgaard, Shauna M; Ruben, Kerry; Wendicke, Annemarie

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: October 2015


Editor’s Note: This Practice Brief supersedes the July 2012 “Data Quality Management Model (Updated),” the March 1998 “Checklist to Assess Data Quality Management Efforts,” and the June 1998 “Data Quality Management Model” Practice Briefs.


Managing a Data Dictionary (2016 update) - Retired

Author: Davoudi, Sion; Flanigan, Jill; Houser, Shannon H.; Kadlec, Lesley; Kirby, Annessa; VanSlyke, Daniel; Wendicke, Annemarie

Source: AHIMA practice brief

Publication Date: December 2016


This update supplants the 2012 practice brief “Managing a Data Dictionary.”


As healthcare organizations move to the electronic environment, the large volume and complexity of data collected is growing at unprecedented rates. While access to data has the potential to en....

Clinical Validation: the Next Level of CDI (December 2016 update)

Author: Denton, Debra Beisel; Endicott, Melanie; Ericson, Cheryl E; Love, Tammy R.; McDonald, Lori; Willis, Daphne

Source: AHIMA practice brief

Publication Date: December 2016


One of the more challenging tasks for both coding and clinical documentation improvement (CDI) professionals is clinical validation. This is a relatively new responsibility that has evolved as CDI programs mature and CDI and coding professionals advance their knowledge and collaboration on clin....

Navigating a Compliant Breach Management Process

Author: Downing, Katherine

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: June 2014

The purpose of AHIMA’s new Breach Management Toolkit is to provide a comprehensive collection of resources and best practices to help healthcare organizations and health information management (HIM) professionals navigate their way through the Health Insurance Portability and Accountability Act (HIPAA) Breach Notification Rule and the overall breach management process. The toolkit is intended to raise awareness of the importance and responsibility of everyone within the organization to report HIPAA breaches to the appropriate designated personnel, as well as provide breach prevention education and training.

Information Asset Inventory for Information Governance - Retired

Author: Downing, Kathy; Fahy, Kristi; Foster, MeShawn; Hermann, Michelle; Meehan, Ann M.; Washington, Lydia; Woebkenberg, Jami

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: February 2017


When an organization begins to implement an enterprise information governance (IG) program, one of the major initial tasks is to understand the scope and types of information in its possession. An inventory of an organization’s information is necessary in order to facilitate decision maki....

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