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Exam (elaborations)

CCS Exam Preparation, Domain 4: Regulatory Compliance questions and correct answers

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CCS Exam Preparation, Domain 4: Regulatory Compliance questions and correct answers

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Ccs
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Ccs











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CCS Exam Preparation, Domain 4: Regulatory
Compliance questions and correct answers
1. After consulting with a physician, a D. No, internal policies cannot conflict
cod- ing supervisor has issued an with requirements provided in
internal poli- cy stating that all coding guide- lines, conventions,
bedside debridement be coded as and so on.
excisional. Is this an ethical prac-
tice for a coding professional to follow? Why Ethical Coding Guideline 1.2
states that in-
or why not? ternal policies may not conflict with
the cod- ing rules, conventions,
A. Yes, physician guidance provided guidelines, etc. of the coding
basis for the policy. classifications nor with any ofl- cial
coding advice (AHIMA House of Dele-
gates 2016).
B. Yes, coding professionals must follow in-
ternal policies of the facilities where
they are employed.

C. No, coding supervisors cannot
make in- ternal policies without
approval of adminis- tration.

D. No, internal policies cannot conflict
with requirements provided in
coding guide- lines, conventions,
and so on.

2. The coding supervisor is concerned that pa- C. Obtain the cases of
malignant colon tu-
tients diagnosed with carcinoid what work processes
colon tu- mors were miscoded as could be under-
malignant during the last six taken?
months. To address this situa- tion,
1/
42

,CCS Exam Preparation, Domain 4: Regulatory
Compliance questions and correct answers
A. Obtain the cases of carcinoid mors from both the cancer registry
colon tu- mors from the cancer and the billing system; import both
registry, obtain the cases of lists into a spreadsheet and compare
malignant colon tumors from the them. Identify the cases that are not
billing system, import both lists in the tumor registry but are coded
into a as malignant in the billing system.
These cases should be manually
reviewed to ensure they are not
carcinoid tumors.

The diagnostic index can be used
with




2/
42

,CCS Exam Preparation, Domain 4: Regulatory
Compliance questions and correct answers
spreadsheet, and compare them. The cases the cancer registry data to
undertake data
in the cancer registry but not coded as radiation. A member
car- cinoid in the billing system are of the medical staff
likely malig- nant and should be who was not
manually reviewed. associated with the
patient's care requests
B. Compare the cases from the chart to see the patient's
com- pletion software with the health record. What
billing software. Identify the cases should the coding
that are not in the billing system. professional do?
These cases should be manually
reviewed to ensure they are not
carcinoid tumors.

C. Obtain the cases of malignant
colon tu- mors from both the cancer
registry and the billing system;
import both lists into a spreadsheet
and compare them. Identify the
cases that are not in the tumor registry
but are coded as malignant in the
billing system. These cases should
be manually reviewed to ensure
they are not carcinoid tumors.

D. Compare the cases from the
transcrip- tion tracking software to the
billing system. Identify the

3. The patient was admitted for prostate
car- cinoma. This was treated with

3/
42

, CCS Exam Preparation, Domain 4: Regulatory
Compliance questions and correct answers
quality analysis (Johns 2020, 85).




D. Explain that providing the record would violate the
privacy policy

This question relates to the need-to-know principle. The
medical statt member who is not associated with the
patient's care


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42

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