Clinical Coding Audit Program - CCAP Level 1
Overview
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Every CHI-regulated provider in the Kingdom of Saudi Arabia must complete an initial internal clinical coding audit by 31 December 2026, then four audits a year, one in each calendar quarter, with annual external audits beginning 1 January 2027 through CHI-approved vendors. From 1 January 2028, DRG-based reimbursement becomes mandatory for all admitted care — and from that point the clinical record drives the code, the code drives the DRG, and the DRG determines what the provider is paid for care already delivered. The Kingdom does not have enough coding auditors to meet that obligation. This program equips health information management professionals to meet it: to audit a medical record against the published CHI Clinical Coding Audit Methodology V2.0, to score it with arithmetic a provider can reproduce by hand, and to produce a report the facility can defend. The five sessions carry the participant from the regulatory framework through the Standardized Coding Audit Template, the eighteen published error codes and their fixed deductions, the accuracy and completeness scoring model, sampling by provider category, and grading against the 80% certification threshold. Every session carries applied work on real, de-identified Saudi medical records spanning inpatient, outpatient, day case and emergency encounters. |
This Activity for
- All Audience, But the greatest benefit will be to these Professions.
- Other health care provider
- Respiratory Therapy
- Psychology
- Podiatry
- Physiotherapy
- Optometry
- Clinical Nutrition
- Nursing and Midwifery
- Dentistry and Related Specialties
- Resident / Fellow
- Physician
- Pharmacy
- Occupational Therapy
- Clinical Laboratory Sciences
- Non Health Care Provaider
- Healthcare & Hospital Administration
- Health Education
- Health Informatics
- Speech Disorder
- Public and Community Health
- Clinical Pharmacy
- Medical Education
- Emergency Medical Services
- Radiological Technology
- Audiology
- Medical Technology
- Social Service
- Sociology
- Cardiac Perfusion
- Technicians and Health Assistants
- Dental Technology and Assistants
- Resident
- Pharmacists and Pharmacy Technicians
- Laboratories and Medical Technology
- Health Administration and Community Health
- Therapy and Rehabilitation
- Assistive Listening Devices
- Non Health Care Provider
- Speech-Language Pathology
- Educational Institution
What I will learn?
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1. Apply the CHI Clinical Coding Audit Methodology V2.0 to a full medical record, by independently re-coding the encounter from the documentation before reading the submitted codes, and by recording the variance between the two positions. 2. Assign the eighteen published error codes with their correct severity and fixed deductions, by distinguishing accuracy errors from completeness errors and applying the four assignment principles to each finding. 3. Calculate a record result by holding the accuracy and completeness positions separately from a starting point of 100, and combining them at the published weighting of 70% and 30% — rather than applying the lower-of-two rule. 4. Determine an audit sample from a facility's provider category, by identifying the annual claim volume band, applying the published sample size, and allocating it across inpatient, day case, outpatient and emergency encounters using the published ratios. 5. Interpret a facility audit result against the 80% certification threshold, by assigning the correct grade and stating the consequence that follows — including the 90-day re-audit where a provider falls below the minimum. 6. Draft a compliant, non-leading physician query from an audit finding, by stating the documentation that exists and asking a specific clinical question, so that the query produces a defensible record rather than a leading response. |
About Organizer
- Virtual Medical Academy
Additional items to the activity
| Optional Details | Type | Fee |
|---|---|---|
| Clinical Coding Audit Program - CCAP Level 1 | Certificate | Free |