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[Show more]Assign code(s) for the following diagnosis: Congestive heart failure due to hypertension. 
I10 Essential (primary) hypertension 
I11.9 Hypertensive heart disease without heart failure 
I11.0 Hypertensive heart disease with heart failure 
I50.9 Heart failure, unspecified 
I50.1 Left ventricular failu...
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Add to cartAssign code(s) for the following diagnosis: Congestive heart failure due to hypertension. 
I10 Essential (primary) hypertension 
I11.9 Hypertensive heart disease without heart failure 
I11.0 Hypertensive heart disease with heart failure 
I50.9 Heart failure, unspecified 
I50.1 Left ventricular failu...
OIG 
Office of Inspector General- established by the Dept. of Labor by the Inspector General Act of 1978 to identify fraud and abuse of Medicare part A and part B programs 
 
 
 
MAC 
Medicare Administrative Contractor - used by the OIG to process claims for services rendered 
 
 
 
 
Brainpower 
Re...
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Add to cartOIG 
Office of Inspector General- established by the Dept. of Labor by the Inspector General Act of 1978 to identify fraud and abuse of Medicare part A and part B programs 
 
 
 
MAC 
Medicare Administrative Contractor - used by the OIG to process claims for services rendered 
 
 
 
 
Brainpower 
Re...
Cert 
Comprehensive error testing rate 
 
 
 
Cpt 
Current procedural terminology. The amas list of 5 digit codes used to report outpatient hospital and Physicians Medical and surgical services. CPT is used to report outpatient or Physician Office claims only and is updated annually in January. 
 
 ...
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Comprehensive error testing rate 
 
 
 
Cpt 
Current procedural terminology. The amas list of 5 digit codes used to report outpatient hospital and Physicians Medical and surgical services. CPT is used to report outpatient or Physician Office claims only and is updated annually in January. 
 
 ...
AHIMA 
American Health Information Management Association 
 
 
 
ACDIS 
Association of Clinical Documentation Improvement Specialists 
 
 
 
 
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IDT 
Interdisciplinary Team 
 
 
 
LOS 
Length of Stay 
 
 
 
The RHIT, RHIA or CCS should have how many years of inpatient coding exp...
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Add to cartAHIMA 
American Health Information Management Association 
 
 
 
ACDIS 
Association of Clinical Documentation Improvement Specialists 
 
 
 
 
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IDT 
Interdisciplinary Team 
 
 
 
LOS 
Length of Stay 
 
 
 
The RHIT, RHIA or CCS should have how many years of inpatient coding exp...
7 Criteria for High Quality Documentation 
Legibile 
Reliable 
Precision 
complete 
consistent 
clarity 
timeliness 
 
 
 
Legibility 
Required under all government and regulatory agencies 
 
 
 
 
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Reliability 
treatment provided without documentation of condition being treate...
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Add to cart7 Criteria for High Quality Documentation 
Legibile 
Reliable 
Precision 
complete 
consistent 
clarity 
timeliness 
 
 
 
Legibility 
Required under all government and regulatory agencies 
 
 
 
 
Brainpower 
Read More 
Reliability 
treatment provided without documentation of condition being treate...
MAC 
Medicare Administrative Contractor 
 
 
 
RAC 
Recovery Audit Contractor 
 
 
 
 
Brainpower 
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Denial rate is calculated by 
Dividing the number of claims or line items denied, by the number of claims or line items submitted 
 
 
 
Query response rate 
the number of responses from the...
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Add to cartMAC 
Medicare Administrative Contractor 
 
 
 
RAC 
Recovery Audit Contractor 
 
 
 
 
Brainpower 
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Denial rate is calculated by 
Dividing the number of claims or line items denied, by the number of claims or line items submitted 
 
 
 
Query response rate 
the number of responses from the...
Coding Clinic 
Valuable reference tool for coders that is published by AHA each quarter 
 
 
 
CPT 
Current Procedural Terminology 
 
 
 
 
Brainpower 
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MS-DRGs 
Medicare Severity-Diagnosis Related Groups 
 
 
 
CPT Assistant 
Monthly publication by the AMA that provides coding advice for ...
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Add to cartCoding Clinic 
Valuable reference tool for coders that is published by AHA each quarter 
 
 
 
CPT 
Current Procedural Terminology 
 
 
 
 
Brainpower 
Read More 
MS-DRGs 
Medicare Severity-Diagnosis Related Groups 
 
 
 
CPT Assistant 
Monthly publication by the AMA that provides coding advice for ...
POA 
Present on admission 
 
 
 
Concurrent reviews 
CDI specialist reviews the patient record while the patient is in the hospital 
 
 
 
 
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Ethical 
Conforming to accepted standards of conduct 
 
 
 
Ethical Queries 
Queries that do not lead the physician to a particular answ...
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Add to cartPOA 
Present on admission 
 
 
 
Concurrent reviews 
CDI specialist reviews the patient record while the patient is in the hospital 
 
 
 
 
Brainpower 
Read More 
Ethical 
Conforming to accepted standards of conduct 
 
 
 
Ethical Queries 
Queries that do not lead the physician to a particular answ...
Denial Rate 
Number of Claims or line items denied 
/ number of claims or lines items submitted 
 
 
 
Query Response Rate 
Number of Query Responses 
/ Number of Queries Written 
 
 
 
 
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Escalation Policy 
Provides a specific list of management and other authorities that must...
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Add to cartDenial Rate 
Number of Claims or line items denied 
/ number of claims or lines items submitted 
 
 
 
Query Response Rate 
Number of Query Responses 
/ Number of Queries Written 
 
 
 
 
Brainpower 
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Escalation Policy 
Provides a specific list of management and other authorities that must...
ROM 
Risk of mortality 
 
 
 
SOI 
Severity of illness 
 
 
 
 
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MCC 
Major complication or comorbidity 
 
 
 
CC 
Complication or comorbidity 
 
 
 
MS-DRG 
Medicare Severity-Diagnosis Related Group 
 
 
 
LOS 
Length of stay 
 
 
 
CDI 
Clinical Documentation Improvement 
 
 ...
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Add to cartROM 
Risk of mortality 
 
 
 
SOI 
Severity of illness 
 
 
 
 
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MCC 
Major complication or comorbidity 
 
 
 
CC 
Complication or comorbidity 
 
 
 
MS-DRG 
Medicare Severity-Diagnosis Related Group 
 
 
 
LOS 
Length of stay 
 
 
 
CDI 
Clinical Documentation Improvement 
 
 ...
Why hire Medicare Contractor Reviewers? 
For Protection of Medicare Trust Fund. 
 
 
 
Who is 1st of 6 Medicare Contract Reviewers? 
(MACs) Medicare Administrative Contractors 
 
 
 
 
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Whos is 2nd of 6 Medicare Contract Reviewers? 
(RACs) Recovery Auditor Contractors 
 
 
 
Wh...
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Add to cartWhy hire Medicare Contractor Reviewers? 
For Protection of Medicare Trust Fund. 
 
 
 
Who is 1st of 6 Medicare Contract Reviewers? 
(MACs) Medicare Administrative Contractors 
 
 
 
 
Brainpower 
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Whos is 2nd of 6 Medicare Contract Reviewers? 
(RACs) Recovery Auditor Contractors 
 
 
 
Wh...
A physician documents pneumonia of the left lower lobe with crackles in the bases. The patient has difficulty swallowing day 2 of admission following CVA with infarct. The patient has a history of gastroesophageal reflux. It would be appropriate to query for: 
 
A. No query warranted 
B. Infectious ...
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Add to cartA physician documents pneumonia of the left lower lobe with crackles in the bases. The patient has difficulty swallowing day 2 of admission following CVA with infarct. The patient has a history of gastroesophageal reflux. It would be appropriate to query for: 
 
A. No query warranted 
B. Infectious ...
Accurate Coding Impacts 
Medicare Severity Diagnosis Related Groups (DRGs) 
All Patient Refined (APR) - DRG 
Reimbursement 
Length of Stay (LOS) 
 
 
 
What is CDI 
Clinical Documentation Improvement - Concurrent review of the chart to make sure documentation is complete to capture accurate coding a...
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Add to cartAccurate Coding Impacts 
Medicare Severity Diagnosis Related Groups (DRGs) 
All Patient Refined (APR) - DRG 
Reimbursement 
Length of Stay (LOS) 
 
 
 
What is CDI 
Clinical Documentation Improvement - Concurrent review of the chart to make sure documentation is complete to capture accurate coding a...
Who sets the official Guidelines for coding and reporting (ICD-10)? 
American Hospital Associates (AHA) 
American Health information management association (AHIMA) 
National Center for Health Statistics (NCHS) 
Center for Medicare and Medicaid Services (CMS) 
 
 
 
AHA 
Serves as a clearing house fo...
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Add to cartWho sets the official Guidelines for coding and reporting (ICD-10)? 
American Hospital Associates (AHA) 
American Health information management association (AHIMA) 
National Center for Health Statistics (NCHS) 
Center for Medicare and Medicaid Services (CMS) 
 
 
 
AHA 
Serves as a clearing house fo...
AHIMA 
American Health Information Management Association - Does Education 
 
 
 
AMA 
American Medical Association - Manages the CPT level 1 Codes 
 
 
 
 
AHA 
American Hospital Association - Does the Coding Clinic which is updated quarterly 
 
 
 
Ways to Promote CDI 
Flyers, Newsletters, Blogs. ...
Preview 2 out of 7 pages
Add to cartAHIMA 
American Health Information Management Association - Does Education 
 
 
 
AMA 
American Medical Association - Manages the CPT level 1 Codes 
 
 
 
 
AHA 
American Hospital Association - Does the Coding Clinic which is updated quarterly 
 
 
 
Ways to Promote CDI 
Flyers, Newsletters, Blogs. ...
Principal Diagnosis 
The disease or condition that was present on admission, was the principal reason for admission, and received treatment or evaluation during the hospital stay or visit for the reason established after study to be chiefly responsible for occasioning the admission of the patient to...
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Add to cartPrincipal Diagnosis 
The disease or condition that was present on admission, was the principal reason for admission, and received treatment or evaluation during the hospital stay or visit for the reason established after study to be chiefly responsible for occasioning the admission of the patient to...
POA 
Present on admission 
 
 
 
Concurrent reviews 
CDI specialist reviews the patient record while the patient is in the hospital 
 
 
 
 
Brainpower 
Read More 
Ethical 
Conforming to accepted standards of conduct 
 
 
 
Ethical Queries 
Queries that do not lead the physician to a particular answ...
Preview 1 out of 2 pages
Add to cartPOA 
Present on admission 
 
 
 
Concurrent reviews 
CDI specialist reviews the patient record while the patient is in the hospital 
 
 
 
 
Brainpower 
Read More 
Ethical 
Conforming to accepted standards of conduct 
 
 
 
Ethical Queries 
Queries that do not lead the physician to a particular answ...
Once certified, a tumor registrar pays an annual fee to the NCRA and, therefore, does not have to particpate in continuing education 
False 
 
 
 
Coding and reimbursement specialist can obtain employment in a variety of health care settings 
True 
 
 
 
 
Brainpower 
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A health information...
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Add to cartOnce certified, a tumor registrar pays an annual fee to the NCRA and, therefore, does not have to particpate in continuing education 
False 
 
 
 
Coding and reimbursement specialist can obtain employment in a variety of health care settings 
True 
 
 
 
 
Brainpower 
Read More 
A health information...
Coding Clinic 
Valuable reference tool for coders that is published by AHA each quarter 
 
 
 
CPT 
Current Procedural Terminology 
 
 
 
 
Brainpower 
Read More 
MS-DRGs 
Medicare Severity-Diagnosis Related Groups 
 
 
 
CPT Assistant 
Monthly publication by the AMA that provides coding advice for ...
Preview 2 out of 6 pages
Add to cartCoding Clinic 
Valuable reference tool for coders that is published by AHA each quarter 
 
 
 
CPT 
Current Procedural Terminology 
 
 
 
 
Brainpower 
Read More 
MS-DRGs 
Medicare Severity-Diagnosis Related Groups 
 
 
 
CPT Assistant 
Monthly publication by the AMA that provides coding advice for ...
Chief Knowledge Officer (CKO) 
leads development, management, and sharing of knowledge within a health care organization for the purpose of improving patient care. No credential needed but can work in variety of places with skills in general management 
 
 
 
Health Information Managers 
Experts in ...
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Add to cartChief Knowledge Officer (CKO) 
leads development, management, and sharing of knowledge within a health care organization for the purpose of improving patient care. No credential needed but can work in variety of places with skills in general management 
 
 
 
Health Information Managers 
Experts in ...
Clinical Documentation Improvement 
 
 
 
Organizations strive to continuously improve their clinical documentation through organized clinical documentation improvement (CDI) programs (realizing that strong CDI program means hiring and training skilled CDI specialists). The purpose of a CDI program ...
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Add to cartClinical Documentation Improvement 
 
 
 
Organizations strive to continuously improve their clinical documentation through organized clinical documentation improvement (CDI) programs (realizing that strong CDI program means hiring and training skilled CDI specialists). The purpose of a CDI program ...
T/F: During a survey, the accrediting body will utilize the state's standards for licensure as an accrediting guide, without exceptions. 
False 
 
 
 
T/F: Medicare Quality indicators are criteria that, if present in a patient's record, are likely to result in higher quality of care than if they a...
Preview 1 out of 2 pages
Add to cartT/F: During a survey, the accrediting body will utilize the state's standards for licensure as an accrediting guide, without exceptions. 
False 
 
 
 
T/F: Medicare Quality indicators are criteria that, if present in a patient's record, are likely to result in higher quality of care than if they a...
Systems analyst 
Tasks include data collection, data analysis and developing data flow diagrams; they would assist in the reengineering of business process that would take advantage of the benefits of the system being implemented. 
 
 
 
health information management 
an allied health profession tha...
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Add to cartSystems analyst 
Tasks include data collection, data analysis and developing data flow diagrams; they would assist in the reengineering of business process that would take advantage of the benefits of the system being implemented. 
 
 
 
health information management 
an allied health profession tha...
RHIT MOCK EXAM CENGAGE EXAM QUESTIONS AND ANSWERS 2024
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Add to cartRHIT MOCK EXAM CENGAGE EXAM QUESTIONS AND ANSWERS 2024
ocumentation, coding accuracy, policies and procedures 
 
ensure practitioners are compliant and meet all coding and billing regulations of payer when submitting a claim 
 
Medical record Auditing entails conducting internal or external reviews of which of these: 
I. documentation 
II. coding accura...
Preview 2 out of 5 pages
Add to cartocumentation, coding accuracy, policies and procedures 
 
ensure practitioners are compliant and meet all coding and billing regulations of payer when submitting a claim 
 
Medical record Auditing entails conducting internal or external reviews of which of these: 
I. documentation 
II. coding accura...
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