System and method for optimizing medical diagnosis, procedures and claims using a structured search space

A computer program for optimizing medical diagnosis, procedures and reimbursement claims using a structured search space, the computer program comprising:

• instructions for listing alphanumeric codes that represent each of a plurality of medical procedures to produce a master procedure list, wherein the master procedure list includes simple procedures and compound procedures which consist of at least two simple procedures;
• instructions for associating a value to each of the plurality of medical procedures;
• instructions for listing medical procedures for a specific medical encounter to produce a list of ordered procedures;
• instructions for building a search tree of all possible combinations of the simple procedures and the compound procedures in the list of ordered procedures;
• and
• instructions for searching the search tree for the optimal total of values associated with the medical procedures in the list of ordered procedures.

A system for optimizing medical diagnosis, procedures and reimbursement claims using a structured search space, the system comprising:

• a master procedure list of alphanumeric codes that represent each of a plurality of medical procedures, wherein the master procedure list includes simple procedures and compound procedures which consist of at least two simple procedures;
• a value associated with each of the plurality of medical procedures;
• a list of ordered procedures listing medical procedures for a specific medical encounter;
• a search tree of all possible combinations of the simple procedures and the compound procedures in the list of ordered procedures;
• and
• a minimum total of the values associated with the medical procedures in the list of ordered procedures.