CDEO Exam Prep |2025| complete exam test
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What is the central focus c. To facilitate optimum patient care
of clinical The central focus of all clinical documentation
documentation? should be to demonstrate the quality of care
a. Protection against mal- provided to the patient with detail and accuracy to
practice claims facilitate optimum patient care.
b. Communication to
office staff and other
departments about the
patient's care
c. To facilitate optimum
patient care
d. Communication to
other the providers and
ancillary personnel
concerning the patient
encounter
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The CDEO will focus his d. No, CDEOs review records on a proactive basis
or her attention on to prevent documentation deficiencies
records requested for Clinical documentation improvement is a proactive
post payment review. measure. The CDS will develop and monitor policies
a. Yes, CDEOs only and procedures that affect the documentation
review records that might process. CDI should begin at the front end of all
be an audit concern and services and care. Prevention of documentation
require physician issues is the key. See Page 1
education.
b. Yes, CDEOs only
review records for paid
claims by government
payers.
c. No, CDEOs do not
review records unless it is
requested by the
compliance officier.
d. No, CDEOs review
records on a proactive
basis to prevent
documentation
deficiencies
The CDEO will review the c. Prevent deficient documentation
findings of the auditor in The CDEO will review the findings of the auditor to
order to: determine what should be done to resolve
a. Reprocess claims documentation the issues on a proactive basis to
b. Make an addendum to prevent documentation and compliance risks.
the medical record
c. Prevent deficient
documentation
d. Know what accounts
should be adjusted off
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I, II, III, and IV
Which of the following For different reasons other than reimbursement,
sources other than requests for medical records come from different
federal healthcare plans sources, for a multitude of different reasons. A few
may request the medical of these, other than Federal Health Care Plans, are
records? patients who are becoming more active in their care
I. Patients , attorneys seeking information for third party
II. Providers involved with liability claims or mal-practice claims, other
the patient's care providers involved in the patients' care, employers
III. Employers for for pre-employment applications and worker's
worker's compensation compensation cases, private payers, recruiting
claims offices for military applications, and the social
IV. Private payers security administration for the patients' SSI
applications.
In addition to facilitating a. The appropriateness of the services provided
high quality patient care, In addition to facilitating high quality patient care, a
a properly documented properly documented medical record verifies and
medical record verifies documents precisely what services were actually
and documents precisely provided. The medical record may be used to
what services were validate: (a) The site of the service; (b) The
actually provided. Other appropriateness of the services provided; (c) The
than the site of service accuracy of the billing; and (d) The identity of the
the medical record may caregiver.
be used to validate:
a. The appropriateness of
the services provided
b. The patient's certificate
of birth
c. The identity of the
patient's extended family
d. The cost of healthcare
benefits used for the
year.
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A provider's best defense c. Detailed, well documented notes
in any legal situation is: The details in a well-documented note are a
a. Patient records provider's best defense in any legal situation. If the
maintained for five years record is deficient in details, there is no "evidence"
b. An experienced to support a provider's testimony.
healthcare attorney
c. Detailed, well
documented notes
d. Updated computer
storage systems
To maintain an accurate c. During the encounter or as soon as possible
medical record, what is The best way to achieve the most accurate, detailed
the recommended documentation is for the provider to document the
appropriate time for encounter/services as soon as possible after (if not
provider documentation? during) the encounter.
a. Within 48 hours of
patient visit
b. A minimum of bi-
weekly
c. During the encounter
or as soon as possible
d. The end of each day
for all encounters that
day
Quality assurance of d. If it is documented in the patient's medical record
patient care is only Quality assurance in patient care is only evident if it
evident if: is documented in the medical record. Quality
a. The patient maintains a services may have been provided; however, if this is
state of optimum health not evident within the medical record, problems
b. Visits are only required may arise.
for well-checks or injury
c. The patient survey and
ROS does not change
d. If it is documented in
the patient's medical
record
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