CDEO EXAM PACK QUESTIONS & ANSWERS(GRADED A+)

PHI - ANSWER-Protected Health Information Privacy Rule - ANSWER-Protects all individually identifiable health information held or transmitted by a covered entity or business associate in any form or media whether electronic, paper, or oral. Protected Health Information - ANSWER-Includes the in...

RBRVS - ANSWER-Resource-Based Relative Value Scale RBRVS System - ANSWER-Established by Medicare to reimburse physicians based on CPT code submitted for reimbursement RVU - ANSWER-Each CPT code has an assigned relative value unit which, when multiplied by conversion factor and a geographic reg...

PREDICTIVE MODELING - ANSWER-is an analytical review of known data elements to establish a hypothesis related to the future health needs of patients or a population of patients Suspect Logic - ANSWER-Many organizations utilize a method such as this one to uncover diagnoses which are likely presen...

HEDIS - ANSWER-Healthcare Effectiveness Data and Information Set QBPs - ANSWER-Quality bonus payments 5 Stars - ANSWER-Excellent Performance 4 Stars - ANSWER-Above Average Performance 3 Stars - ANSWER-Average Performance 2 Stars - ANSWER-Below Average Performance 1 Star - ANSWER-Po...

Documentation states that the patient had a "Status post hysterectomy. The patient presents with a fever." Which of the following would be a compliant question to query? - ANSWER-Do you know the cause of the fever? Operation Restore Trust - ANSWER-3 offices were involved: OIG, Healthcare Financ...

What are the three areas of the ear - ANSWER-The three areas of the ear are 1. Auricle, No. 2. Inner Ear: Tympanic cavity, and No. 3 Inner Ear: cochlea. What are the titles of the two ENT list areas listed in the CPT book ? - ANSWER-The ENT services are listed in two separate sections: 1. Auditor...

Review approaches to skin, integumentary system L - ANSWER-Approaches to Skin include: 1. Introduction and removal, 2. Incision and drainage, 3. Debridement, 4. Pairing or cutting, 5. Biopsy, 6. Removal of skin tags, 7. Shaving of epidermal or dermal lesions, 8. Excision--benign lesions, 9. Excision...

Health Insurance Portability and Accountability Act of 1996 - ANSWER-(HIPAA) August 21, 1996 - ANSWER-HIPAA was enacted on _________. Kennedy-Kassebaum - ANSWER-HIPAA aka as ______ bill, was originally enacted to provide rights and protections for participants and beneficiaries of group health...

c. To facilitate optimum patient care The central focus of all clinical documentation should be to demonstrate the quality of care provided to the patient with detail and accuracy to facilitate optimum patient care. - ANSWER-What is the central focus of clinical documentation? a. Protection agains...

HIPPA - ANSWER-Health Insurance Portability and Accountability Act of 1996 and the Healthcare Fraud and abuse control program. Far-reaching program to combat fraud and abuse in healthcare including both public and private health plans. Individuals protected health information - ANSWER-Demographic...

Congestive Heart Failure - ANSWER-A chronic condition in which the heart doesn't pump blood as well as it should. Hypertension - ANSWER-A condition in which the force of the blood against the artery walls is too high. HEDIS - ANSWER-Healthcare Effectiveness Data and Information Set HIPAA -...

What is the central focus of clinical documentation? - ANSWER-To facilitate optimum patient care The CDEO will review the findings of the auditor in order to: - ANSWER-Prevent deficient documentation Which sources other than federal healthcare plans may request the medical records? - ANSWER-Pa...