HIMT 1250 Documentation for Health records Final Exam Review || A+ Guaranteed.
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Course
HIMT 1250
Institution
HIMT 1250
Long term care hospitals must meet requirements for _____________ and have an agreement with ____________ in order to receive payments correct answers Acute care hospitals, Medicare
The ___________ established the Common Clinical Data Set correct answers "ONC" Office of the National Coordinator
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HIMT 1250 Documentation for Health records Final Exam
Review || A+ Guaranteed.
Long term care hospitals must meet requirements for _____________ and have an agreement
with ____________ in order to receive payments correct answers Acute care hospitals, Medicare
The ___________ established the Common Clinical Data Set correct answers "ONC" Office of
the National Coordinator
Documentation that supports that skilled services are medically reasonable & necessary correct
answers Medical Necessity
Medicare Quality indicators are criteria that, if present in a patients record, are likely to result in
higher quality of care than if they are not present correct answers True
The Healthcare Effectiveness Data and Information Set contains standard________________
correct answers Performance Measures
What provides a wide range of services to include nursing care, 24-hour supervision, assistance
with activities of daily living and rehabilitation services such as physical, occupational, & speech
therapy correct answers SNF Skilled Nursing Facilities
Under the centers for Medicare and Medicaid services Comprehensive (CERT) Program which
of the following is not a common documentation error in the Ambulatory Care correct answers
History and physical within 30 days
Which of the following is an unacceptable signature on a home health plan of care correct
answers Stamped signature
which chapter of HCPCS would you find drugs administered intravenously correct answers J
Codes
The objective of Rx-Norm is to normalize names of generic & brand drugs and attach a
__________ to that name correct answers Rx-Norm concept unique identifier
The __________ is a snapshot of a patient's status & includes everything from social issues to
disease processes, as well as critical paths & clinical pathways that focused on a specific disease
process or pathway correct answers Care Plan
General written guidelines that dictate behavior & or direct & constrain decision making within
the organization are known as what correct answers Policies
Which Joint Commission survey methodology involves an evaluation that follows the hospital
experiences of past or current patients correct answers Tracer Methodology
, ______________questions are preferred to use in queries to avoid limiting or leading provider
responses correct answers Open ended
The ______________ is a derived classification of the (WHO) world health organization family
of international classifications correct answers ICD-03
The OASIS-C1 data elements originate from a _____________ correct answers Medicare-
certified home health agency
Ambulatory surgical centers only provide emergency surgery services correct answers False
surgeries are pre-planned outpatient visit's
CDI professionals are require to be an AHIMA Certified Documentationn Improvement
Practitioner (CDIP) by each state to work in a CDI role, similar to nurse licensure correct
answers False
The purpose of this program is to identify and reduce improper Medicare payments & prevent
future improper payments for healthcare services correct answers Recovery Audit Contractors
What type of outpatient facility is operated by local governments correct answers Community
Health Center
Which acute-care accrediting body integrates the Medicare (COP)conditions of participation)
with the ISO 9001 Quality Management Program correct answers DNV GL Healthcare
AHIMA defines a query as a ____________ tool used to clarify documentation in the health
record for accurate code assignment correct answers Communication
The UMLS ____________ contains the terminology, classification & code system standards
correct answers Metathesaurus
A patients rights to be informed about any financial liability is governed by the Patient Self-
Determination Act of 1990 correct answers False
According to CMS, who is qualified to collect the OASIS data? correct answers Register Nurse
Medicare is the major payer of home health. Which of the following is an incorrect statement
regarding Medicare's impact on documentation correct answers Government programs typically
decrease the documentation burden, because eligibility is straightforward.
What is designed for people who want to live in a community setting and who need or expect to
need help functioning, but who do not need as much care as a nursing home correct answers
Assisted living
Within what period of time after admission to an LTCH must the history and physical be
completed and placed in the health record correct answers 24 hours
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