HIT 230 - CHAPTER 2 EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

HIT 230 - CHAPTER 2 EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 Hospital Inpatient pg 32 - Answers an individual receiving health care services as well as room and board and continuous nursing care in a hospital unit where patients generally stay overnight. Hospital Outpatient pg 32 - Answers a hospital patient who receives care at the hospital but who is not admitted as an inpatient Clinic Outpatient pg 32 - Answers an outpatient treated in an organized clinic of the hospital, in which hospital staff evaluate the patient and manage the patient's care. Referred Hospital Outpatient pg 32 - Answers an outpatient who is referred to the hospital for specific services, such as laboratory or radiology examinations. The hospital is responsible only for providing the diagnostic or therapeutic services requested, while the referring physician is responsible for evaluating and managing the patient's care. Emergency outpatient pg 33 - Answers an outpatient evaluated and treated in the emergency department of the hospital Hospitalist pg 33 - Answers a physician who specializes in inpatient medicine Residents pg 39 - Answers primarily licensed physicians, dentists, or podiatrists who participate in an approved graduate medical education (GME) program. The term resident also may be applied to physicians with temporary or restricted licenses, or unlicensed graduates of foreign medical schools who are authorized to practice only in a hospital. Chargemaster or Charge description master (CDM) pg 40 - Answers a computer file that contains a list of the Healthcare Common Procedural Coding System codes and associated charges for services provided to hospital patients. Current Procedural Terminology (CPT) pg 41 - Answers a coding system developed and maintained by the American Medical Association for use by health care providers in reporting procedures to third-party-payers for reimbursement. Fiscal intermediary (FI) pg 41 - Answers before the implementation of MACs, an organization with a contract with CMS to process and pay Part A Medicare claims Medicare carrier pg 41 - Answers before the implementation of MACs, an organization having a contract with the CMs to process and pay Part B Medicare claims Medicare Administrative Contractor (MAC) pg 41 - Answers an organization that has contract with the CMs to process Medicare claims. MACs have replaced fiscal intermediaries and Medicare carriers Hospital Inpatient Prospective Payment System (HIPPS or IPPS) pg 42 - Answers Medicare's payment system for hospital inpatient services. The basic unit of payment in the IPPS is the Medicare Severity Diagnosis Related Group (MS-DRG) Diagnosis related group (DRG) pg 42 - Answers groupings of inpatient services (based on the diagnosis, expected resource consumption, and other characteristics) that determine the payment the hospital receives under the Hospital Inpatient Prospective Payment System (HIPPS) Medicare Severity Diagnosis Related Groups (MS-DRGs) pg 42 - Answers groupings of inpatient services (based on the diagnosis, expected resource consumption, and other characteristics) that determine the payment the hospital receives under the Hospital Inpatient Prospective Payment System (HIPPS) The Medicare severity system adjusts the original DRG algorithm for severity by classifying some complications and comorbidities as major complications and comorbidities (MCCs), indicating the potential for higher resource consumption when an MCC is present. Severity of Illness pg 44 - Answers the extent of physical illness or loss of organ function of the patient. Ranked on a scale of 1 to 4, indicating mild (1), moderate (2), major (3), or extreme (4) severity. Risk of Mortality pg 44 - Answers the likelihood that the patient will die while in the hospital. Ranked on a scale of 1 to 4, indicating mild (1), moderate (2), major (3), or extreme (4) risk of mortality. Hospital Outpatient Prospective Payment System (HOPPS or OPPS) pg 44 - Answers Medicare's payment system for hospital outpatient services. The basic unit of payment in the OPPS is the ambulatory payment classification (APC) of each service provided. Ambulatory Payment Classification (APCs) pg 44 - Answers grouping of outpatient services (based on the HCPCS code assigned) that determine the payment the hospital receives under the Hospital Outpatient Prospective Payment System (HOPPS) Healthcare Common Procedural Coding System (HCPCS) pg 45 - Answers the system required by CMS for coding services provided to Medicare patients. Status indicator pg 45 - Answers an alphabetic character that indicates the type of each APC and whether or how that APC is paid under the Hospital Outpatient Prospective System (OPPS) Discounted pg 45 - Answers reduced payment for additional procedures or ambulatory patient groups. When discounted, these other items are not paid at the full rate, as they would be if they had been the only services performed in a given encounter. Revenue Codes pg 52 - Answers used on the UB-04 to indicate the general nature of the services provided. American Recovery and Reinvestment Act (ARRA) pg 53 - Answers a federal law that, among other things, created an incentive program for health care providers to utilize EHRs for improved patient care. Uniform Hospital Discharge Data Set (UHDDS) pg 54 - Answers standard data elements to be collected from individual inpatient records. The UHDDS data definitions are essential for correct reporting of inpatient data, for example on the UB-04. Uniform Ambulatory Care Data Set (UACDS) pg 54 - Answers a 16-item data set approved by the National Committee on Vital and Health Statistics (NCVHS); one of the first attempts to standardize ambulatory data collection efforts. Potentially Compensable Events (PCEs) pg 58 - Answers occurrences that may result in litigation against the health care provider or that may require the health care provider to financially compensate an injured party. Emergency Medical Treatment and Active Labor Act (EMTALA) pg 59 - Answers a federal law that imposes a legal duty on hospitals to screen and stabilize, if necessary, any patient who arrives in the emergency department. The purpose of EMTALA is to prevent the "dumping" of patients who may not be able to pay for emergency department services. What is the difference between hospital inpatient care and hospital-based ambulatory care? - Answers Inpatient short-term acute care is the type of care generally associated with hospitals. Patients who are in need of around-the-clock acute care are admitted as hospital inpatients upon the order of a physician. Hospital-based ambulatory care can involve outpatient surgical care, clinic care, or emergency room care. When a patient is admitted under observation services, the physician must determine whether the patient meets inpatient criteria within what time frame? - Answers 24 Hours What does PHP stand for, and how does it differ from inpatient care? - Answers PHP stands for a partial hospitalization program, in which the patient may receive a variety of services such as individual or group therapy; occupational therapy; diagnostic services; services of social workers, psychiatric nurses, and other staff; along with other types of services on an outpatient basis. Name and discuss three types of patients. - Answers (1) Hospital inpatients are acutely ill individuals who are treated in an area of the hospital where patients generally stay overnight. (2) A hospital outpatient is a patient who is evaluated or treated at a hospital facility but is not admitted as an inpatient. (3) Long-term acute care hospital patients are admitted to a long-term care hospital (LTCH) and are generally more acutely ill than patients in other long-term care settings. What is a hospitalist, and what is the advantage to the patient when a hospital has one? - Answers A hospitalist is a physician who provides comprehensive care to hospitalized patients but who ordinarily does not see patients outside of the hospital setting. The advantage to the patient is that the hospitalist is a specialist in dealing with conditions that require hospitalization and is not distracted by the duties of seeing patients in the clinic setting. What is the difference between licensure and accreditation? - Answers Hospitals must be licensed by the state in which they are located. Hospitals voluntarily seek accreditation to demonstrate to their patients, to their communities, to insurers, to managed care organizations, and to others that their organizations are providing quality care. What federal requirements must an organization meet to receive Medicare payments? - Answers Conditions of Participation What three accrediting organizations are "deemed" to be in compliance with the federal Conditions of Participation? - Answers The Joint Commission, the AOA's Healthcare Facilities Accreditation Program (HFAP), and DNV Healthcare's NIAHO program True or False? A medical history and physical examination must be recorded in the medical record within 12 hours after a procedure is performed. - Answers False—Should be placed before a procedure is performed.