The conversion factor is the national dollar multiplier that sets the allowance for the
relative values—a constant (Casto and Forrestal 2013, 157).
A Joint Commission accredited organization must review their formulary annually to
ensure a medications continued: - Answer efficacy and safety
P...
The conversion factor is the national dollar multiplier that sets the allowance for the
relative values—a constant (Casto and Forrestal 2013, 157).
A Joint Commission accredited organization must review their formulary annually to
ensure a medications continued: - Answer efficacy and safety
Part of the coding supervisor's responsibility is to review accounts that have not been
final billed due to errors. One of the accounts on the list is a same-day procedure. Upon
review, the coding supervisor notices that the charge code on the bill was hard-coded.
The ambulatory procedure coder added the same CPT code to the abstract. How should
this error be corrected? - Answer Remove the code from the abstract and counsel the
coder regarding CDM hard codes for this service.
In performing an internal audit for coding compliance, which of the following would be
suitable case selections for auditing? - Answer Medical and surgical MS-DRGs by high
dollar and high volume
In the HHPS system, which home healthcare services are consolidated into a single
payment to home health agencies? - Answer Nursing and therapy services, routine and
non routine medical supplies, home health aid visits.
The coder assigned separate codes for individual tests when a combination code exists.
This is an example of what? - Answer Unbundling
Community Hospital implemented a clinical documentation improvement (CDI) program
6 months ago. The goal of the program was to improve clinical documentation to
support quality of care, data quality, and HIM coding accuracy. Which of the following
, shows the importance of this program? - Answer Include ancillary clinical staff and
medical staff in the process
The accounts receivable collection cycle involves the time from: - Answer Admission to
deposit to the bank
In a typical acute care setting aging of account reports are monitored in which revenue
cycle? - Answer Accounts receivable
The lead coder in the HIM department is an acknowledged coding expert and is the go
to person in the healthcare entity for coding guidance. As the HIM director you learn
that she is not following proper guidelines and coding practices are not compliant. The
best steps to take would be to: - Answer Review the coding errors and counsel the
employee
To meet the definition of an inpatient rehab facility (IRF) facilities must have an
inpatient population with at least a specified percentage of patients with certain
conditions. Which condition is counted in the definition? - Answer Brain injury
Medicaid coverage is not identical in New Jersey, California, and Idaho. Why is this? -
Answer Medicaid allows states to maintain a unique program adapted to state residents
needs and average income
What is it called when accrediting bodies such as Joint Commission can survey facilities
for compliance with the Medicare Conditions of Participation for hospitals instead of the
government? - Answer Deemed status
Which of the following items are packaged under the Medicare hospital outpatient
prospective payment system (OPPS) - Answer Supplies (other than pass-through) and
recovery room
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