CDC Case Study - Healthcare Resolution Services

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HCRS Partners with RTI to Provide Coding Services for the CDC


HCRS received a task order from a prime contractor, RTI, to provide technical support services to the CDC’s Division of Health Care Statistics under Domain 1 for Survey Design and Implementation.


The National Ambulatory Medical Care Survey (NAMCS) is a nationally representative survey about the provision and use of ambulatory medical care services in the United States. Findings are based on a sample of visits to non-federally employed, office-based physicians who are primarily engaged in direct patient care. The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital emergency and outpatient departments, and in hospital-based ambulatory surgery locations.

A systematic, random sample of patient visits are recorded by interviewers for the U.S. Census Bureau using a computerized patient record form. This sample includes patient characteristics such as age, sex, race, and ethnicity, as well as the patient’s reason for their visit, their provider’s diagnosis, services ordered or provided, and treatments (including medication therapy). In addition, data about the facility are collected as part of a survey induction interview.

Survey scientists code text data verbatim, using ICD-10-CM for diagnosis and cause of injury, CPT for procedure except where NCHS requires modifications, and NCHS Reason for Visit (RFV) Classification for RFV data items.

Key Strategies

We employed survey scientists, associate survey scientists, and associate computer programmers to complete the five-year task order, which included: 

  • Management of electronic data following FAR 52.204-21.
  • Coding of verbatim text at 98% accuracy.
  • Providing electronic data files to NCHS, following NIST SP 800-191.
  • Verifying all cybersecurity standards and regulations.

We secured support for data processing in NAMCS and NHAMCS — namely coding verbatim text into appropriate coding systems using ICD-10-CM for diagnosis and cause of injury, and ICD-10-PCS for procedure codes.

Key Requirements

  1. We protected federal contract information (FCI) systems through:
    a. Integrity, by guarding against improper information modification or destruction, and ensuring information nonrepudiation and authenticity.
    b. Confidentiality, by preserving authorized restrictions on data access and disclosure, including means for protecting personal privacy and proprietary information.
    c. Availability, by ensuring timely and reliable access and use of information.
  2. We adopted and implemented the policies, procedures, controls, and standards of the HHS Information Security Program.
  3. We ensured all electronic information systems and data collection met security assessment and authorization (SA&A) prior to the contract, in compliance with all applicable HHS, CDC, FISMA, HIPAA, NIST, and other federal policies and regulations.

Applicable Cybersecurity Standards and Regulations

  • Federal Information Security Modernization Act (FISMA)
  • Risk Management Framework (RMF)
  • FedRAMP
  • FAR Clause 52.204-21
  • DFARS Clause 252.204-7012
  • National Institute of Standards and Technology (NIST) SP 800-171
  • NIST SP 800-171A
  • NIST SP 800-172

Does your agency have similar coding and data management needs? Contact us today at (301) 497-1187, or through our website at