Validating Data

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GretaAnacker
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251821
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Validating Data
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2013-12-08 21:05:28
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VALIDATING DATA
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  1. To implement the OPPS, Medicare assigns a payment status indicator (SI) for every
    A.ICD-9-CM procedure code.
    B.APC.
    C.DRG.
    D.HCPCS and CPT code.
    D.HCPCS and CPT code.
    (this multiple choice question has been scrambled)
  2. Documentation of the "approach" of a surgical procedure would be necessary to assign most
    A. ICD-9-CM diagnosis codes
    B. .DRGs.
    C. APCs.
    D. CPT codes.
    CPT codes.
  3. Critical care CPT codes are based on
    A. diagnosis.
    B. IV infusion time.
    C.physician time.
    D.procedure approach.
    D. physician time
    (this multiple choice question has been scrambled)
  4. Medicare Part A pays for
    A. medical coverage for active-duty and retired service members.
    B.prescription drugs.
    C.inpatient hospitalization.
    D.physician-related services.
    C.inpatient hospitalization.
    (this multiple choice question has been scrambled)
  5. ICD-9-CM diagnosis codes are NOT required for determining
    A.DRG assignment.
    B.home health PPS.
    C.rehabilitation PPS.
    D.APC assignment.
    D.APC assignment.
    (this multiple choice question has been scrambled)
  6. Codes for drugs, pharmaceuticals, and biologicals often begin with
    A.asterisk.
    B.decimal point.
    C. a letter.
    D.number.
    C. a letter.
    (this multiple choice question has been scrambled)
  7. What Medicare organization serves as the financial agent between the providers and the federal government in the local administration?
    A.Department of Health and Human Services
    B.Office of the Inspector General
    C.risk management
    D.Medicare administrative contractors
    D.Medicare administrative contractors
    (this multiple choice question has been scrambled)
  8. In order for an inpatient rehabilitation facility to be reimbursed via the prospective payment system, what must be completed and entered into grouper software?
    A.consent form
    B.DRG
    C.PAI
    D.APC
    C.PAI
    (this multiple choice question has been scrambled)
  9. Major diagnostic categories (MDCs) are divided into groups based on
    A.lengths of stay (LOS).
    B.discharge disposition.
    C.medical and surgical categories.
    D.secondary diagnoses.
    C.medical and surgical categories.
    (this multiple choice question has been scrambled)
  10. MS-DRGs are different than DRGs in that they take into account
    A.the approach of a procedure.
    B.discharge disposition.
    C.complications and comorbidities.
    D.severity of illness.
    D.severity of illness.
    (this multiple choice question has been scrambled)
  11. What has the potential to increase the relative weight of a diagnosis-related group (DRG)?
    A.IV infusion
    B.LOS
    C.chest X-ray
    D.CC
    D.CC
    (this multiple choice question has been scrambled)
  12. Medicare outpatient prospective payment system (PPS) is based on
    A. DRGs.
    B. E/M levels.
    C. APCs.
    D. IRF-PAI.
    C. APCs.
    (this multiple choice question has been scrambled)
  13. What variable is NOT taken into account when assigning a diagnosis-related group (DRG)?
    A. Gender
    B. age
    C. discharge disposition
    D. length of stay
    D. length of stay
    (this multiple choice question has been scrambled)
  14. DRGDRG DescriptionRelative Weight# Patients
    374Digestive Malignancy w/MCC1.9007
    375Digestive Malignancy w/ CC1.25015
    376Digestive Malignancy w/o CC/MCC.882025
    377GI Hemorrhage w/ MCC1.6001014.
    Using the table above, what DRG would provide the most reimbursement based on the patient population?
    377
    376
    374
    375
    376
  15. DRGDRG DescriptionRelative Weight# Patients
    374Digestive Malignancy w/ MCC1.9007
    375Digestive Malignancy w/ CC1.25015
    376Digestive Malignancy w/o CC/MCC.882025
    377GI Hemorrhage w/ MCC1.6001015.
    Using the table above, what is the CMI for this group of patients? You are expected to use a calculator for this scenario.
    A. 1.250
    B. 1.408
    C. 1.229
    D. 1.900
    C. 1.229
    (this multiple choice question has been scrambled)
  16. A POA indicator on all diagnosis codes is required on all
    A. emergency room visits.
    B. inpatient encounters.
    C. inpatient psychiatric admissions.
    D. inpatient rehabilitation admissions.
    B. inpatient encounters.
    (this multiple choice question has been scrambled)
  17. How many diagnosis-related groups (DRGs) can be assigned for an inpatient encounter?
    A. 4
    B. 3
    C. 2
    D. 1
    D. 1
    (this multiple choice question has been scrambled)
  18. What organization is responsible for the maintenance of coding clinics for ICD-9-CM?
    A. AHA
    B. CMS
    C. AHIMA
    D. NCHS
    A. AHA
    (this multiple choice question has been scrambled)
  19. What type of reimbursement is a diagnosis-related group (DRG)?
    A. fee schedule
    B. capitation
    C. fee for service
    D. prospective payment system
    D. prospective payment system
    (this multiple choice question has been scrambled)
  20. When is a physician query appropriate?
    A. if there is an abnormal lab finding not correlated in the documentation
    B. for every discrepancy not addressed in the physician documentation
    C. when the discharge summary is not complete
    D. when there is conflicting information in the record
    D. when there is conflicting information in the record
    (this multiple choice question has been scrambled)
  21. What Medicare organization serves as the financial agent between the providers and the federal government in the local administration?
    A. Department of Health and Human Services
    B. risk management
    C. Medicare administrative contractors
    D. Office of the Inspector General
    C. Medicare administrative contractors
    (this multiple choice question has been scrambled)
  22. Critical care CPT codes are based on
    A. IV infusion time.
    B. diagnosis.
    C. physician time.
    D. procedure approach.
    C. physician time.
    (this multiple choice question has been scrambled)
  23. MS-DRGs are different than DRGs in that they take into account
    A. discharge disposition.
    B. complications and comorbidities.
    C. the approach of a procedure.
    D. severity of illness.
    D. severity of illness.
    (this multiple choice question has been scrambled)
  24. ICD-9-CM diagnosis codes are NOT required for determining
    A. rehabilitation PPS.
    B. DRG assignment.
    C. home health PPS.
    D. APC assignment.
    D. APC assignment.
    (this multiple choice question has been scrambled)

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