CERTIFIED CODING SPECIALIST
QUESTIONS AND CORRECT
SOLUTIONS
Where are POA guidelines found in ICD-10-cm ✅✅ANSW-Appendix 1
Which two forms are submitted to Medicare ✅✅ANSW-UB-04, A37 institutional form
a provider is considered a ✅✅ANSW-physician or any qualified healthcare practitioner who
legally is accountable for establishing the patients diagnosis
POA - Y ✅✅ANSW-Present at the time of inpatient admission
POA - N ✅✅ANSW-Not present at the time of inpatient admission
POA - U ✅✅ANSW-documentation is insufficient to determine whether condition was present on
admission
POA - W ✅✅ANSW-Provider is unable to clinically determine whether condition was present of
not
POA - Unreported/Not used ✅✅ANSW-Exempt from POA reporting typically history codes '1' for
Medicare usage
Hospital Acquired conditions ✅✅ANSW-These conditions are not present at the time of
admission
Section 5001 (c) of the reduction act of 2005 requires the secretary to identify conditions that are
______ cost or _____ volume ✅✅ANSW-high, or high
For discharges occurring on/after October 1, 2008 hospitals will ______ receive additional payment
for cases in where one of the selected conditions was not present on admission ✅✅ANSW-not
, If it was not POA, they do not pay for it even if it was _______ ✅✅ANSW-treated
Inpatient prospective payment system ✅✅ANSW-IPPS
Under the _____ each case is categorized into a DRG ✅✅ANSW-Inpatient prospective payment
system
One _____ group per admission ✅✅ANSW-DRG
MS-DRG variables ✅✅ANSW--principal diagnosis
-secondary diagnosis
-principal or significant procedure
-age/sex
-patient states- discharge disposition
What is applicated for each MS-DRG to represent the average resources essential for the patient
assigned to that particular DRG grouping ✅✅ANSW-Relative weight
Relative weight is updated ______ ✅✅ANSW-Annually
Relative weight is published in the ____ _____ and the updated _____ ____ ____ ______ regulations
Oct every year ✅✅ANSW-federal register , Inpatient prospective payment system
Complication ✅✅ANSW-is a diagnosis that describes a condition arising after the beginning of
hospital observation and treatment and then modifying the course of pts illness or the medical care
required
comorbidty ✅✅ANSW-defined as a pre existing condition that because of its presence with a
specific principal diagnosis will likely cause an increase to the pts length of stay in hospital
Current MS-DRG is a _____ tierd system ✅✅ANSW-three
QUESTIONS AND CORRECT
SOLUTIONS
Where are POA guidelines found in ICD-10-cm ✅✅ANSW-Appendix 1
Which two forms are submitted to Medicare ✅✅ANSW-UB-04, A37 institutional form
a provider is considered a ✅✅ANSW-physician or any qualified healthcare practitioner who
legally is accountable for establishing the patients diagnosis
POA - Y ✅✅ANSW-Present at the time of inpatient admission
POA - N ✅✅ANSW-Not present at the time of inpatient admission
POA - U ✅✅ANSW-documentation is insufficient to determine whether condition was present on
admission
POA - W ✅✅ANSW-Provider is unable to clinically determine whether condition was present of
not
POA - Unreported/Not used ✅✅ANSW-Exempt from POA reporting typically history codes '1' for
Medicare usage
Hospital Acquired conditions ✅✅ANSW-These conditions are not present at the time of
admission
Section 5001 (c) of the reduction act of 2005 requires the secretary to identify conditions that are
______ cost or _____ volume ✅✅ANSW-high, or high
For discharges occurring on/after October 1, 2008 hospitals will ______ receive additional payment
for cases in where one of the selected conditions was not present on admission ✅✅ANSW-not
, If it was not POA, they do not pay for it even if it was _______ ✅✅ANSW-treated
Inpatient prospective payment system ✅✅ANSW-IPPS
Under the _____ each case is categorized into a DRG ✅✅ANSW-Inpatient prospective payment
system
One _____ group per admission ✅✅ANSW-DRG
MS-DRG variables ✅✅ANSW--principal diagnosis
-secondary diagnosis
-principal or significant procedure
-age/sex
-patient states- discharge disposition
What is applicated for each MS-DRG to represent the average resources essential for the patient
assigned to that particular DRG grouping ✅✅ANSW-Relative weight
Relative weight is updated ______ ✅✅ANSW-Annually
Relative weight is published in the ____ _____ and the updated _____ ____ ____ ______ regulations
Oct every year ✅✅ANSW-federal register , Inpatient prospective payment system
Complication ✅✅ANSW-is a diagnosis that describes a condition arising after the beginning of
hospital observation and treatment and then modifying the course of pts illness or the medical care
required
comorbidty ✅✅ANSW-defined as a pre existing condition that because of its presence with a
specific principal diagnosis will likely cause an increase to the pts length of stay in hospital
Current MS-DRG is a _____ tierd system ✅✅ANSW-three
