{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:55:17Z","timestamp":1790751317943,"version":"4.1.0"},"update-to":[{"DOI":"10.12688\/f1000research.183114.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000}}],"reference-count":35,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Jenderal Achmad Yani Yogyakarta University","award":["ThisresearchwassupportedandFinancedbyJenderalAchmadYaniYogyakartaUniversity"],"award-info":[{"award-number":["ThisresearchwassupportedandFinancedbyJenderalAchmadYaniYogyakartaUniversity"]}]},{"name":"Jenderal Achmad Yani Yogyakarta University","award":["throughcampusgrantsbasedonworkagreementletternumberSTB\/03\/FKES\/II\/2021"],"award-info":[{"award-number":["throughcampusgrantsbasedonworkagreementletternumberSTB\/03\/FKES\/II\/2021"]}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Introduction In casemix-based payment systems, clinical coding quality plays a critical role in determining data validity, reimbursement accuracy, and overall performance. Financial inefficiencies, skewed morbidity data, and claim denials might result from incorrect coding. However, the majority of studies pay little attention to thorough and context-specific evaluation, instead concentrating mostly on coding accuracy. Objective The purpose of this study was to use the Indonesian Case-Based Groups (INA-CBG) as the empirical backdrop for the development and psychometric validation of a multidimensional instrument for evaluating clinical coding quality in casemix systems. Methods An instrument development strategy based on ICD-10, ICD-9-CM, WHO coding guidelines, national casemix requirements, and results from coding audits was used to conduct a methodological investigation. The Content Validity Ratio (CVR) and Content Validity Index (I-CVI, S-CVI) were used to evaluate the content validity. Cohen\u2019s Kappa was used to assess inter-rater reliability, while Cronbach\u2019s alpha with 95% confidence intervals was used to quantify internal consistency. JASP was used for data analysis. Results The Clinical Coding Quality Assessment Instrument for Casemix (CCQAI\u2013CM) comprises seven conceptual domains operationalized through 11 assessment items: diagnosis documentation, procedure documentation, documentation support, coding compliance, coding accuracy, diagnosis reselection, and procedure reselection. The instrument demonstrated high content validity (S-CVI = 0.972), varying item-level inter-rater agreement, and very high overall internal consistency (Cronbach's \u03b1 = 0.982). Conclusion The findings provide initial evidence of the content validity and reliability of the CCQAI\u2013CM as a multidimensional framework for assessing clinical coding quality in casemix systems. Further validation across healthcare settings and against relevant casemix outcomes is warranted.<\/ns3:p>","DOI":"10.12688\/f1000research.183114.2","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T08:59:05Z","timestamp":1789635545000},"page":"1138","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Psychometric Validation of a Multidimensional Clinical Coding Quality Assessment Instrument in Casemix Systems"],"prefix":"10.12688","volume":"15","author":[{"given":"Kori","family":"Puspita Ningsih","sequence":"first","affiliation":[{"name":"Doctoral Program in Public Health Surakarta Central Java 57126 Faculty of Medicine, Universitas Sebelas Maret"},{"name":"Department Of Medical Record and Health Information, Faculty of Health Sleman Daerah Istimewa Yogyakarta 55294 Universitas Jenderal Achmad Yani Yogyakarta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartono","family":"Hartono","sequence":"additional","affiliation":[{"name":"Department of Public Health Surakarta Central Java 57126 Faculty of Medicine, Universitas Sebelas Maret"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2484-6126","authenticated-orcid":false,"given":"Nur","family":"Hafidha Hikmayani","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Surakarta Central Java 57126 Faculty of Medicine, Universitas Sebelas Maret"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"ref2","doi-asserted-by":"publisher","first-page":"396-412","DOI":"10.1093\/fampra\/cmh409","article-title":"Quality Of Morbidity Coding In General Practice Computerized Medical Records: A Systematic Review.","volume":"21","author":"K Jordan","year":"2004","journal-title":"Fam. 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We sincerely appreciate your positive assessment and are pleased that the revisions have satisfactorily addressed your previous comments. Your valuable suggestions have helped us improve the clarity and quality of the manuscript. We are truly grateful for your time, expertise, and kind consideration.","URL":"https:\/\/f1000research.com\/articles\/15-1138\/v2#referee-comment-17212","order":1,"name":"referee-comment-17212","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.209477.r520064, Yafi Sabila Rosyad, Mental health nursing , Universitas Bhakti Husada Indonesia, Kuningan, 21 Sep 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/15-1138\/v2#referee-response-520064","order":2,"name":"referee-response-520064","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Kori Puspita Ningsih<\/b>; \n<i>Posted: 22 Sep 2026<\/i>; Thank you very much for your careful and constructive review of our manuscript. We sincerely appreciate your valuable suggestions, which have helped us further improve the clarity, methodological transparency, and consistency of the manuscript. We have carefully considered all of your comments and have made targeted revisions and clarifications where appropriate, particularly regarding the applicability and scoring procedures, conceptual distinctions among items, content validity, inter-rater reliability, and the level of validation and novelty claims. Where additional information or analyses were not available from the original study data or were beyond the scope of the present study, we have clarified the existing procedures and appropriately moderated our interpretation. A detailed point-by-point response will accompany the revised manuscript. We sincerely appreciate your thoughtful recommendations and believe that these revisions have further strengthened the manuscript while preserving the original scope and design of the study.","URL":"https:\/\/f1000research.com\/articles\/15-1138\/v2#referee-comment-17222","order":3,"name":"referee-comment-17222","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This research was supported and Financed by Jenderal Achmad Yani Yogyakarta University, through campus grants based on work agreement letter number STB\/03\/FKES\/II\/2021. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}