CCA Exam Prep from AHIMA Flashcards

What process determines how a claim will be reimbursed based on the insurance benefit?

What part of Medicare covers physician services, outpatient care and home healthcare?

The case mix can be figured by multiplying the relative weight of each MS-DRG by the number of ________ within that MS-DRG.

Computer software programs that assist in the assignment of codes used with diagnostic and procedural classifications are called:

Common forms of fraud and abuse include all of the following except:

Where would information on treatment given on a particular encounter be found in the health record?

To comply with HIPAA, under usual circumstances, a covered entity must act on a patient's request to review or copy his or her health information within ________ days.

What is the name of the organization that develops the billing form that hospitals are required to use?

What is the expectation of the hospital in relation to the OIG work plan?

Calling out patient names in a physician's office is:

The following is documented in an acute-care record: 'Atrial fibrillation with rapid ventricular response, left axis deviation, left bundle branch block.' Where would this documentation be found?

Which of the following situations would be identified by the NCCI edits?

An advantage of computer-assisted coding (CAC) is:

A patient is admitted for chest pain with cardiac dysrhythmia to Hospital A. The appropriate ICD-10-CM codes and sequencing for both hospitalizations must be determined.

A patient requests copies of her personal health information on CD. What should the hospital respond?

The ________ is a type of coding that is a natural outgrowth of the EHR.

What does data definition refer to?

The CIA of security includes confidentiality, data integrity, and data ________.

Written or spoken permission to proceed with care is classified as:

Who is responsible for ensuring the quality of health record documentation?

What quality element is missing from Mrs. Smith's health record regarding her birth date?

HIT professionals must have knowledge of:

Documentation in the history of use of drugs, alcohol, and tobacco is considered as part of the:

Which character in an ICD-10-CM diagnosis code provides information regarding encounter of care?

This document includes a microscopic description of tissue excised during surgery:

Assignment of benefits is a contract between a physician and Medicare in which the physician agrees to bill Medicare directly for covered services and the beneficiary for ________.

To help clarify terms that currently have overlapping meaning, ICD-10-PCS has defined root operations. What is an example of the root operation of Excision?

Patient data collection requirements vary according to healthcare setting. One would expect which of the following data elements would be collected in the MDS, but would not be collected in the UHDDS?

Which part of the problem-oriented medical record is used by many facilities that have not adopted the whole problem-oriented format?

Which of the following contains the physician's findings based on an examination of the patient?

Which of the following is not an accepted accrediting body for behavioral healthcare organizations?

Dr. Jones has signed a statement that all of her dictated reports should be automatically considered approved and signed unless she makes corrections within 72 hours of dictating. What is this called?

What reimbursement system uses the Medicare fee schedule?

A notation for a hypertensive patient in a physician ambulatory care progress note reads: 'Blood pressure adequately controlled.' Which part of a POMR progress note would this notation be written?

This person designs, implements, and maintains a program that ensures conformity to all types of regulatory and voluntary accreditation requirements governing the provision of healthcare products or services:

What penalties can be enforced against a person or entity that willfully and knowingly violates the HIPAA Privacy Rule with the intent to sell, transfer, or use PHI for commercial advantage, personal gain, or malicious harm?

In hospitals, automated systems for registering patients and tracking their encounters are commonly known as ________ systems.

Which statement fails to be true for Medicare coverage?

A 7-year-old patient was admitted to the emergency department for treatment of shortness of breath. What diagnosis should be suspected?

The right of an individual to keep information about himself or herself from being disclosed to anyone is a definition of:

The OIG believes that compliance programs have benefits in addition to submitting accurate claims. This includes all of the following except:

Which of the following fails to meet the CMS classification of a hospital-acquired condition?

Data security refers to:

MS diagnostic-related groups are organized into:

An encoder that takes a coder through a series of questions and choices is called a(n):

What is the first resource Mary Smith, RHIA, should use to design a data collection form for patient admission?

When the CCI editor flags that a comprehensive code and a component code are billed together for the same beneficiary on the same date of service, which will Medicare pay for?

Which statement is not one of the outcomes that can occur as part of auto-adjudication?

Which of the following is not a way that ICD-10-CM improves coding accuracy?

Which organization is responsible for updating the procedure classification of ICD-10-PCS?

This program was initiated by the Balanced Budget Act of 1997 to cover children up to age 19.

Which document provides a complete description to patients about how PHI is used in a healthcare facility?

The National Correct Coding Initiative was developed to control improper coding leading to inappropriate payment for which claims?

Which software application would be used to aid in the coding function in a physician's office?

What is the maximum number of diagnosis codes that can appear on the UB-04 paper claim form locator 67 for a hospital inpatient principal and secondary diagnoses?

What are the conditions identified by CMS that are not present on admission and could be 'reasonably preventable' called?

Which material is not documented in an emergency care record?

Using uniform terminology helps improve which of the following?

When the physician does not specify the method used to remove a lesion during an endoscopy, what is the appropriate procedure?

Which of the following is not reimbursed according to the Medicare outpatient prospective payment system?

The technology commonly used for automated claims processing is called?

Timely and correct reimbursement is dependent on which factor?

Which answer is not required for assignment of the MS-DRG?

In processing a bill under the Medicare outpatient prospective payment system (OPPS) where a patient had three surgical procedures performed during the same operative session, which of the following would apply?

In the laboratory section of CPT, if a group of tests overlaps two or more panels, what should a coder do with the remaining test codes?

Which document directs an individual to bring records to court?

Which of the following is not a function of the discharge summary?

The HIM department is planning to scan medical record documentation. Which of the following methods of scanning would best help HIM professionals monitor the completeness of health records during a patient's hospitalization?

The practice of assigning a diagnosis or procedure code specifically for the purpose of obtaining a higher level of payment is called?

Exceptions to the consent requirement include:

One objective of the Balanced Budget Act (BBA) of 1997 was to?

Before healthcare organizations can provide services, they usually must obtain what by government entities?

The protection measures and tools for safeguarding information and information systems is a definition of?

Both HEDIS and the Joint Commission's ORYX programs are designed to collect data to be used for?

When a provider accepts assignment, this means?

Which of the following threatens the 'need-to-know' principle?

Which ethical principle is followed when an HIT professional ensures that patient information is only released to those who have a legal right to access it?

A patient was scheduled for a colonoscopy, but it was canceled because of a sudden drop in blood pressure. How should this procedure be coded by the hospital?

Identify where the following information would be found in the acute-care record: 'CBC: WBC 12.0, RBC 4.65, HGB 14.8, HCT 43.3, MCV 93.'

The ________ mandated the development of standards for electronic medical records.

The ________ may contain information about diseases among relatives in which heredity may play a role.

Which personnel should be authorized to take a physician's verbal order for the administration of medication?

Medicare's newest claims processing payment contract entities are referred to as?

To improve compliance related to medical record completion, what is the next step after deactivating the parking garage keycard of any physician in poor standing?

Which key principle requires appropriate physician documentation to secure payment from the insurer?

When coding benign neoplasm of the breast, what should the coder do according to the noted section?

Which is a feature of managed care?

A system that provides alerts and reminders to clinicians is a(n):

What security mechanisms should be implemented to prevent snooping through the clinical information system?

According to HIPAA regulations, was the HIM clerk's action correct in removing copies of the patient's records from another hospital where the patient was previously treated?

If a provider believes a service may be denied by Medicare because it could be considered unnecessary, what must the provider notify the patient with?

What error has the coder made by using the codes for a patient who had a total abdominal hysterectomy with a bilateral salpingo-oophorectomy?

Notices of privacy practices must be available at the treatment site and must be posted where?

What is the function of physician's orders?

Which of the following provides macroscopic and microscopic information about tissue removed during an operative procedure?

Tissue transplanted from one individual to another of the same species, but different genotype is called a(n):

In what form of health information exchange are data centrally located but physically separated?

Fee schedules are updated by third-party payers how often?

Under which part of Medicare is a Medicare Advantage Plan (like an HMO or PPO) classified?