Which organization oversees coding claims in the United States?

The Centers for Medicare and Medicaid Services (CMS) is the primary organization that oversees coding claims in the United States. CMS plays a critical role in the healthcare industry, especially concerning the Medicare and Medicaid programs, which are vital for public health coverage. This organization establishes the guidelines for coding and billing processes that healthcare providers must follow to ensure proper reimbursement for services rendered.

In this context, CMS works with various coding systems like ICD-10 (for diagnoses) and CPT (for procedures), which are essential for the accurate submission of claims. It also monitors compliance among providers, ensuring that coding practices adhere to federal regulations and standards. By doing so, CMS helps to maintain the integrity of healthcare services and ensures that providers are reimbursed accurately for the services they deliver.

The other organizations listed serve different roles within the healthcare landscape. The American Medical Association (AMA) is involved in the development of the Current Procedural Terminology (CPT) coding system but does not oversee coding claims directly. The National Institutes of Health (NIH) primarily focuses on medical research and does not handle coding issues. The World Health Organization (WHO) operates on an international level and is involved in global health matters, but it does not regulate coding claims in the United States.