A written audit report including title page including “confidential – attorney-client privilege – do not reproduce. Table of contents and the following sections:

               – Background

              – Scope

               – Sample

               – General Findings & Recommendations

              –  Specific Findings and Recommendations

              –  Follow-up (refunds, education etc.)


Background:  As a health information professional, it is essential that you are able to audit the quality of ICD 10 CM coding.  This exercise will introduce you to the world of coding audits.




*OIG Model Compliance Plan for Hospitals: https://oig.hhs.gov/authorities/docs/cpghosp.pdf


*How to Choose the Right Coding Audit Method, AHIMA BoK: https://bok.ahima.org/doc?oid=302442#.XQ0XUYhKi70


*Best Practices in Coding Audits: https://www.fortherecordmag.com/archives/0118p10.shtml


Learning Objectives:  After completing of this exercise the student will be able to:

  • Audit for coding accuracy
  • Evaluate coding accuracy
  • Summarize the findings, including developing a list of recommendations for improvement.