CCS Exam 94 QUESTIONS WITH COMPLETE SOLUTIONS

Relational database structures Correct Answer: An entity relationship diagram was developed to depict A data map or crosswalk consists of: Correct Answer: Terms used to describe paths between classifications and vocabularies An object-oriented database contains: Correct Answer: Data and their relationships within a single structure Structured query language Correct Answer: The most common language used for both data defintion language and data manipulation language Manipulation CPT Correct Answer: Is the same as "Reduction" in ICD9 Outpatient Prospective Payment System (OPPS) began Correct Answer: To be used for Medicare in August 2000. Ambulatory Payment Classification (APCs) Correct Answer: Reimbursement for hospital-based outpatient services such as outpatient surgery, emergency department visits, outpatient clinic visits, and outpatient ancillary tests. How are APCs similar to MS-DRGs? Correct Answer: They are both prospective payment methodologies and both have relative weights How are APCs different from MS-DRGs? Correct Answer: Outpatients can have multiple APCs for a given encounter, whereas an inpatient can have only one MS-DRG. What services are generated with APCs? Correct Answer: X-rays, medical tests, clinic or emergency visits, surgical procedures, devices, drugs and biologicals, and parital hospitalizations. What is the billing number in APCs? Correct Answer: The billing number is the connecting identifier for a given patients encounter that results in multiple APCs. Case Mix Correct Answer: A description of patient population based on any number of specific characteristics, including age, gender, type of insurance, diagnosis, risk factors, treatment received, and resources used. Case-mix index Correct Answer: The average relative weight of all cases treated at a given facility or by a physician, Case Mix Index Correct Answer: Is the average of all weight together with highest sum. Ex: 3.7533÷3=1.2511 Case Mix Correct Answer: Is all the weights add together. Ex: 0.7870 + 1.1510 +1.4653= 3.7533 Medical Staffbylaws Correct Answer: The requirements for documentation and record completion (documents such as history and physicals, discharge summaries, and consultations) as well as penalties for nonaherence must be specified. Data Quality Correct Answer: Ensuring the accuracy and completeness of an organization's data.