What types of tools are used to analyze data and what type of data may be produced?
Data mining and some pattern recognition is used to look for instances of potential fraud, as well as, for reporting purposes to determine if performance goals are being met. • Will the system derive new data, or create previously unavailable data, about an individual through aggregation of the collected information? The system provides images of existing data (bills, correspondence), adjudicates bills for payment determination and transmits payment files for federal certification. • If the system uses commercial or publicly available data, please explain why and how it is used. CBP uses the following medical code reference files obtained from third party vendors to adjudicate the bill for payment determination: • International Classification of Diseases, version 9 (ICD-9) • Diagnoses Related Group (DRG) • Current Procedural Terminology System (CPTS) • Health Care Common Procedural Coding System (HCPCS) • National Drug Codes (NDC) • Privacy Impact Analysis All system users are required
