AHIMA CCS Exam Prep Questions With Complete Solutions (Verified And Updated)

AHIMA CCS Exam Prep Questions With Complete Solutions (Verified And Updated) CPT defines a separate procedure as - answerProcedure considered an integral part of a more major service No combination code available - answerUse separate codes for hypertension and acute renal failure Documentation from the nursing staff or other allied health professionals' notes can be used to provide specificity for code assignment for which of the following diagnoses? - answerBody Mass Index (BMI) POA Indicator - Y - answerY-Yes, present at the time of inpatient admission POA Indicator - N - answerN-No, not present at the time of inpatient admission POA Indicator - U - answerU-Unknown, documentation is insufficient to determine if condition is present on admission and you cannot speak to the physician to figure it out POA Indicator - W - answerW-Clinically undetermined, provider is unable to clinically determine whether condition was present on admission or not POA Indicator - E - answerE-Exempt, unreported/not used, some facilities will leave these blank, others will use the letter "E" Present on Admission Indicator (POA) - answerA Present On Admission (POA) indicator is required on all diagnosis codes for the inpatient setting except for admission. The indicator should be reported for principal diagnosis codes, secondary diagnosis codes, Z-codes, and External cause injury codes. The use of the outpatient code editor (OCE) is designed to: - answerIdentify incomplete and incorrect claims Medicare's identification of medically necessary services is outlined in: - answerLocal Coverage Determinations (LCDs) Medically unlikely edits are used to identify: - answerMaximum units of service for a HCPCS code National Correct Coding Initiative (NCCI) Edits are released how often? - answerQuarterly In 2000, CMS issued the final rule on the outpatient prospective payment system (OPPS). The final rule: - answerDivided outpatient services into fixed payment groups Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs) are similar in that they are both: - answerProspective payment systems What are APCs? - answerAPCs or "Ambulatory Payment Classifications" are the government's method of paying facilities for outpatient services for the Medicare program. How do APCs work? - answerThe payments are calculated by multiplying the APCs relative weight by the OPPS conversion factor and then there is a minor adjustment for geographic location. APC Status Indicator - C - answerInpatient Procedures, not paid under OPPS APC Status Indicator - N - answerItems and Services Packaged into APC Rates APC Status Indicator - S - answerSignificant Procedure, Not Discounted When Multiple APC Status Indicator - T - answerSignificant Procedure, Multiple Reduction Applies APC Status Indicator - V - answerClinic or Emergency Department Visit APC Status Indicator - X - answerAncillary Services APC Status Indicator - Y - answerNon-Implantable Durable Medical Equipment Medicare exerts control of provider reimbursement through adjustment of this component of the resource-based relative value scale (RBRVS) - answerConversion factor The process of collecting data elements from a source document is known as: - answerAbstracting What piece of claims data from hospital A alerts a payer that the patient was transferred to hospital B? - answerDischarge disposition Admission source code used to identify a patient admitted to the facility from home: - answerNon-Healthcare Facility Admission source code used to identify a patient admitted to the facility from hospice care: - answerTransfer from hospice When a patient is transferred from an acute care facility to a skilled nursing home facility, what abstracted data element can impact the DRG assignment? - answerDischarge disposition A complication or comorbidity - answerHypernatremia - A high concentration of sodium in the blood. Hypernatremia most often occurs in people who don't drink enough water.