BCACP ACTUAL EXAM QUESTIONS AND ANSWERS

BCACP ACTUAL EXAM QUESTIONS AND ANSWERS What does FDA do? - ANSWER- approves new medication and issues warnings or other recommendations for already approved meds What does CMS and HHS do? - ANSWER- determine rules and rags for federally sponsored health care or Medicare and other national health care laws What does CDC do? - ANSWER- determines rules and standard procedures for point of care testing, immunizations, and mgmt of patients with transmittable diseases What org are NCQA, PCMH, joint commission, CPPA? - ANSWER- accreditation organizations, establish standards for quality a safety. NCQA? - ANSWER- works to improve health care quality through the administration of utilizes evidence-based standards, measures, programs, and accreditation. The private, nonprofit organization operates on a formula of measure, analyze, and improve. And it aims to build consensus across the industry by working with policymakers, employers, doctors, and patients, as well as health plans. What measures does NCQA have? - ANSWER- Hedis (Healthcare Effectiveness Data and Information Set Which recent law changed the landscape for documentation, creating meaninguf use initiatives? Incentivizes health care organization to use electronic portals for documentation - ANSWER- American recovery and reinvestment act of 2009 What organization sets the national strategy for quality improvement? - ANSWERAHRQ agency for healthcare research and quality What is the public resource for evidence based quality measures? - ANSWER- national quality measures clearinghoue (NQMC) What does the IOM institute of medicine do? - ANSWER- independent, nonprofit, role is to work outside govt to provide unbiased and authoritative adice to decision makers and the public Pharmacy quality alliance role? - ANSWER- ensure provision of quality services to Medicare beneficiaries and all patients Why was NCQA founded in 1979? - ANSWER- to review PPO and HMO Who uses the HEDIS that NCQA developed? - ANSWER- for employers to evaluate the health plans they use for employee benefits What else does NCQA provide? - ANSWER- ACO accreditation, PCMH recognition, diabetes mgmt rec program What is the CPPA established in 2012? - ANSWER- The Center for Pharmacy Practice Accreditation (CPPA) recognizes pharmacy practices that provide an advanced level of patient care, services, quality, and safety who does the five star program? - ANSWER- medicare what are the 5 stars? - ANSWER- staying healthy, managing chronic conditions, member satisfaction, customer service, and pharmacy services. What are the pharmacy HEDIS measures? - ANSWER- managing asthma, Lipids, BP control, BB after MI, What does medicare B cover? - ANSWER- outpatient services Are pharmacists covered as providers under part B? - ANSWER- No What is the HCPCS? - ANSWER- healthcare common procedure coding system, level 1 are the CPT codes 5 digit CPT codes that start with 99 mean what? - ANSWER- services related to physician visit in the amcare setting Are ICD codes required? - ANSWER- Yes, justification of services Why would you need an NPI? - ANSWER- for electronic billing What is incident to billing? - ANSWER- an indirect billing mech whereby auxiliary personnel under their scotp or practic eprovide patient care services under the direct supervision of a physicion or other approved medicare B provider Main requireemnts of incident to billing? - ANSWER- Patient must be an established patient (seen in last 3 years), face to face, medically ncessary, part of the physician bill in the physician office, physician must be actively involved Can MTM use incident to codes? - ANSWER- NO what are the incident to codes? what can pharmacists use? - ANSWER- 99211 to 99215 (increase in level of decisionmaking and length etc); 99211 What are diabetes education codes? - ANSWER- G0108 (individual visit), G0109 (group visit) in 30 minute increments What are the AWV codes? initial, subsequent? - ANSWER- G0402, G0438 (initial), G0439 (subsequent) who can do AWV? - ANSWER- physician, nonphysician practitioner (PA, NP, clinical nurse spcialist, medial professioal) AWV has 10 to does - ANSWER- l What is an incident - to visit? - ANSWER- transition of care visit waht are the indicent to codes and what do they mean? - ANSWER- 99496 (seen in 7 days from discharge), 99495 (seen within 14 days of discharge) what provided us with the opportunity for MTM services? - ANSWER- medicare prescription drug, improvemnt and modernization act of 2003 what are the eligibility requirements for MTM? - ANSWER- 3 chronic health conditions, 5-9 core chronic conditions, 8 part D meds, costs of 3017 or greater what are teh MTM CPT codes? - ANSWER- 99605 (new patient initial 15 min), 99606 (established patient face to face, 15 min), 99607 (face to face visit for extra 15 minutes 4 committees within the senate have jurisdiction over halth related policy - ANSWERappropriation committee (discretionary programs), finance committee (taxation and