{"id":"https://openalex.org/W4405114055","doi":"https://doi.org/10.4324/9781003542872-9","title":"Medical Necessity","display_name":"Medical Necessity","publication_year":2024,"publication_date":"2024-12-06","ids":{"openalex":"https://openalex.org/W4405114055","doi":"https://doi.org/10.4324/9781003542872-9"},"language":"en","primary_location":{"id":"doi:10.4324/9781003542872-9","doi":"https://doi.org/10.4324/9781003542872-9","is_oa":false,"landing_page_url":"https://doi.org/10.4324/9781003542872-9","pdf_url":null,"source":{"id":"https://openalex.org/S4306463855","display_name":"Routledge eBooks","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/P4310319847","host_organization_name":"Routledge","host_organization_lineage":["https://openalex.org/P4310319847","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Routledge","Taylor & Francis"],"type":"ebook platform"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical Documentation, Billing, and Coding for the Advanced Practice Nurse","raw_type":"book-chapter"},"volume":{"id":"https://openalex.org/W4405116101","display_name":"Medical Documentation, Billing, and Coding for the Advanced Practice Nurse"},"type":"book-chapter","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5016733222","display_name":"Carol Berger","orcid":"https://orcid.org/0000-0001-5902-1760","observed_orcids":["https://orcid.org/0000-0001-5902-1760"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Carol Berger","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5044900206","display_name":"Theresa Galakatos","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Theresa Galakatos","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":null,"display_name":"Nina A. Zimmermann","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Nina A. Zimmermann","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.51005917,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":"203","last_page":"213"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T14400","display_name":"Medical Coding and Health Information","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T14400","display_name":"Medical Coding and Health Information","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.0010000000474974513,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.0005000000237487257,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/medical-necessity","display_name":"medical necessity","score":1.0},{"id":"https://openalex.org/keywords/medical-billing","display_name":"medical billing","score":0.8349999785423279},{"id":"https://openalex.org/keywords/medical-coding","display_name":"medical coding","score":0.9649999737739563},{"id":"https://openalex.org/keywords/meaningful-use","display_name":"meaningful use","score":0.8740000128746033},{"id":"https://openalex.org/keywords/electronic-health-records","display_name":"electronic health records","score":0.9869999885559082},{"id":"https://openalex.org/keywords/cms","display_name":"CMS","score":0.5910000205039978},{"id":"https://openalex.org/keywords/healthcare-reimbursement","display_name":"health care reimbursement","score":0.6970000267028809},{"id":"https://openalex.org/keywords/quality-of-care","display_name":"quality of care","score":0.6209999918937683}],"concepts":[{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.3005518913269043}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.4324/9781003542872-9","doi":"https://doi.org/10.4324/9781003542872-9","is_oa":false,"landing_page_url":"https://doi.org/10.4324/9781003542872-9","pdf_url":null,"source":{"id":"https://openalex.org/S4306463855","display_name":"Routledge eBooks","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/P4310319847","host_organization_name":"Routledge","host_organization_lineage":["https://openalex.org/P4310319847","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Routledge","Taylor & Francis"],"type":"ebook platform"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical Documentation, Billing, and Coding for the Advanced Practice Nurse","raw_type":"book-chapter"}],"best_oa_location":null,"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2472189594","https://openalex.org/W2346330043","https://openalex.org/W2252358474","https://openalex.org/W2370231699","https://openalex.org/W2476853526","https://openalex.org/W2009145937","https://openalex.org/W4298313771","https://openalex.org/W7046000054","https://openalex.org/W2897183594","https://openalex.org/W4384697340"],"abstract_inverted_index":{"This":[0],"chapter":[1,56],"explores":[2],"the":[3,33,44],"concept":[4],"of":[5,46,91],"medical":[6,9,59],"necessity":[7,60],"in":[8,17,40],"billing":[10,63],"and":[11,24,64,67,80,95,100],"coding,":[12],"examining":[13],"its":[14],"critical":[15],"role":[16],"ensuring":[18],"that":[19],"services":[20],"provided":[21],"are":[22],"appropriate":[23],"justifiable":[25],"for":[26],"patient":[27,53],"care.":[28],"It":[29],"also":[30],"delves":[31],"into":[32],"Meaningful":[34,69],"Use":[35,70],"program,":[36],"introduced":[37],"by":[38],"CMS":[39],"2012,":[41],"which":[42],"incentivizes":[43],"adoption":[45],"electronic":[47],"health":[48],"records":[49],"(EHR)":[50],"to":[51,76],"improve":[52],"outcomes.":[54],"The":[55],"discusses":[57],"how":[58,68],"underpins":[61],"accurate":[62],"coding":[65],"practices":[66],"criteria":[71],"align":[72],"with":[73],"this":[74,83],"principle":[75],"enhance":[77],"healthcare":[78,102],"quality":[79],"efficiency.":[81],"Through":[82],"exploration,":[84],"readers":[85],"will":[86],"gain":[87],"a":[88],"comprehensive":[89],"understanding":[90],"these":[92],"essential":[93],"concepts":[94],"their":[96],"impact":[97],"on":[98],"compliant":[99],"effective":[101],"practices.":[103]},"counts_by_year":[],"updated_date":"2026-10-10T09:11:00.788812","created_date":"2024-12-07T00:00:00"}