NR |511 |– |FINAL |EXAM |STUDY
|GUIDE
NR 511 – FINAL EXAM STUDY GUIDE
QUESTIONS WITH CORRECT
ANSWERS
WEEK |1
1. Define |diagnostic |reasoning
Reflective |thinking |because |the |process |involves |questioning |one's |thinking |to |determine
|if |all |possible |avenues |have |been |explored |and |if |the |conclusions |that |are |being |drawn
|are |based |on |evidence.
Seen |as |a |kind |of |critical |thinking.
2. Discuss |and |identify |subjective |data?
|What |the |patient |tells |you, |complains |of, |etc.
|Chief |complaint
HPI
|RO
S
3. Discuss |and |identify |objective |data?
What |YOU |can |see, |hear, |or |feel |as |part |of |your |exam. |Includes
|lab |data, |diagnostic |test |results.
Components |of |HPI
4. Discuss |and |identify |the |components |of |the |HPI
|Specifically |related |to |the |chief |complaint |only.
|Detailed |breakdown |of |CC.
OLDCART
5. What |is |medical |coding?
The |use |of |codes |to |communicate |with |payers |about |which |procedures |were |performed
|and |why
6. What |is |medical |billing?
Process |of |submitting |and |following |up |on |claims |made |to |a |payer |in |order |to |receive
|payment |for |medical |services |rendered |by |a |healthcare |provider.
7. What |are |CPT |codes?
Common |procedural |terminology
1
,NR |511 |– |FINAL |EXAM |STUDY
|GUIDE
Offers |the |official |procedural |coding |rules |and |guidelines |required |when |reporting |medical
|services |and |procedures |performed |by |physician |and |non-physician |providers.
8. What |are |ICD |codes?
International |classification |of |disease
Used |to |provide |payer |info |on |necessity |of |visit |or |procedure |performed.
9. What |is |specificity?
2
,NR |511 |– |FINAL |EXAM |STUDY
|GUIDE
The |ability |of |the |test |to |correctly |detect |a |specific |condition.
If |a |patient |has |a |condition |but |test |is |negative, |it |is |a |false |negative.
If |a |patient |does |NOT |have |a |condition |but |the |test |is |positive, |it |is |a |false |positive.
10. What |is |sensitivity?
Test |that |has |few |false |negatives.
Ability |of |a |test |to |correctly |identify |a |specific |condition |when |it |is |present. |The
|higher |the |sensitivity, |the |lesser |the |likelihood |of |a |false |negative.
11. What |is |predictive |value?
The |likelihood |that |the |patient |actually |has |the |condition |and |is, |in |part, |dependent |upon
|the |prevalence |of |the |condition |in |the |population.
If |a |condition |is |highly |likely, |the |positive |result |would |be |more |accurate.
12. Discuss |the |elements |that |need |to |be |considered |when |developing |a |plan
Pt's |preferences |and |actions
|Research |evidence
Clinical |state/circumstances
|Clinical |expertise
13. Describe |the |components |of |Medical |Decision |Making |in |E&M |coding
Risk
|Data
Diagnosis
The |more |time |and |consideration |involved |in |dealing |with |a |pt, |the |higher |the
|reimbursement |from |the |payer.
Documentation |must |reflect |MDM!
evaluation |and |management |(E&M)
14. Correctly |order |the |E&M |office |visit |codes |based |on |complexity |from |least |to |most
|complex
New |patient: Established |patient:
1. Minimal/RN |visit: |99201 Minimal |RN |visit: |99211
2. Problem |focused: |99202 Problem |focused: |99212
3. Expanded |problem |focused: |99203 Expanded |problem |focused: |99213
4. Detailed: |99204 Detailed: |99214
5. Comprehensive: |99205 Comprehensive: |99215
15. Discuss |a |minimum |of |three |purposes |of |the |written |history |and |physical |in
|relation |to |the |importance |of |documentation
Important |reference |document |that |gives |concise |info |about |the |pt's |Hx |and |exam
|findings.
Outlines |a |plan |for |addressing |issues |that |prompted |the |visit. |Info |should |be
|presented |in |a |logical |fashion |that |prominently |features |all |data |relevant |to |the |pt's
|condition.
Is |a |means |of |communicating |info |to |all |providers |involved |in |the |pt's |care.
3
, NR |511 |– |FINAL |EXAM |STUDY
|GUIDE
Is |a |medical-legal |document.
Is |essential |in |order |to |accurately |code |and |bill |for |services.
16. Accurately |document |why |every |procedure |code |must |have |a |corresponding
|diagnosis |code
Diagnosis |code |explains |the |necessity |of |the |procedure |code.
|Insurance |won't |pay |if |they |don't |correspond.
17. Correctly |identify |a |patient |as |new |or |established |given |the |historical |information |If
|that |pt |has |never |been |seen |in |that |clinic |or |by |that |group |of |providers |OR |if |the |pt
|has |not |been |seen |in |the |past |3 |years.
18. Identify |the |3 |components |required |in |determining |an |outpatient, |office |visit |E&M
|code
Place |of |service
|Type |of |service
|Patient |status
19. Describe |the |components |of |Medical |Decision |Making |in |E&M |coding
Risk
|Data
Diagnosis
The |more |time |and |consideration |involved |in |dealing |with |a |pt, |the |higher |the
|reimbursement |from |the |payer.
Documentation |must |reflect |MDM!
evaluation |and |management |(E&M)
20. Explain |what |a |“well |rounded” |clinical |experience |means
Includes |seeing |kids |from |birth |through |young |adult |visits |for |well |child |and |acute |visits, |as
|well |as |adults |for |wellness |or |acute/routine |visits.
Seeing |a |variety |of |pt's, |including |15% |of |peds |and |15% |of |women's |health |of |total |time |in
|the |program.
21. State |the |maximum |number |of |hours |that |time |can |be |spent |“rounding” |in |a
|facility
No |more |than |25% |of |total |practicum |hours |in |the |program
22. State |9 |things |that |must |be |documented |when |inputting |data |into |clinical
|encounter
Date |of |service
|Age
Gender |and |ethnicity
|Visit |E&M |code
CC
Procedures
Tests |performed |and |ordered
4
|GUIDE
NR 511 – FINAL EXAM STUDY GUIDE
QUESTIONS WITH CORRECT
ANSWERS
WEEK |1
1. Define |diagnostic |reasoning
Reflective |thinking |because |the |process |involves |questioning |one's |thinking |to |determine
|if |all |possible |avenues |have |been |explored |and |if |the |conclusions |that |are |being |drawn
|are |based |on |evidence.
Seen |as |a |kind |of |critical |thinking.
2. Discuss |and |identify |subjective |data?
|What |the |patient |tells |you, |complains |of, |etc.
|Chief |complaint
HPI
|RO
S
3. Discuss |and |identify |objective |data?
What |YOU |can |see, |hear, |or |feel |as |part |of |your |exam. |Includes
|lab |data, |diagnostic |test |results.
Components |of |HPI
4. Discuss |and |identify |the |components |of |the |HPI
|Specifically |related |to |the |chief |complaint |only.
|Detailed |breakdown |of |CC.
OLDCART
5. What |is |medical |coding?
The |use |of |codes |to |communicate |with |payers |about |which |procedures |were |performed
|and |why
6. What |is |medical |billing?
Process |of |submitting |and |following |up |on |claims |made |to |a |payer |in |order |to |receive
|payment |for |medical |services |rendered |by |a |healthcare |provider.
7. What |are |CPT |codes?
Common |procedural |terminology
1
,NR |511 |– |FINAL |EXAM |STUDY
|GUIDE
Offers |the |official |procedural |coding |rules |and |guidelines |required |when |reporting |medical
|services |and |procedures |performed |by |physician |and |non-physician |providers.
8. What |are |ICD |codes?
International |classification |of |disease
Used |to |provide |payer |info |on |necessity |of |visit |or |procedure |performed.
9. What |is |specificity?
2
,NR |511 |– |FINAL |EXAM |STUDY
|GUIDE
The |ability |of |the |test |to |correctly |detect |a |specific |condition.
If |a |patient |has |a |condition |but |test |is |negative, |it |is |a |false |negative.
If |a |patient |does |NOT |have |a |condition |but |the |test |is |positive, |it |is |a |false |positive.
10. What |is |sensitivity?
Test |that |has |few |false |negatives.
Ability |of |a |test |to |correctly |identify |a |specific |condition |when |it |is |present. |The
|higher |the |sensitivity, |the |lesser |the |likelihood |of |a |false |negative.
11. What |is |predictive |value?
The |likelihood |that |the |patient |actually |has |the |condition |and |is, |in |part, |dependent |upon
|the |prevalence |of |the |condition |in |the |population.
If |a |condition |is |highly |likely, |the |positive |result |would |be |more |accurate.
12. Discuss |the |elements |that |need |to |be |considered |when |developing |a |plan
Pt's |preferences |and |actions
|Research |evidence
Clinical |state/circumstances
|Clinical |expertise
13. Describe |the |components |of |Medical |Decision |Making |in |E&M |coding
Risk
|Data
Diagnosis
The |more |time |and |consideration |involved |in |dealing |with |a |pt, |the |higher |the
|reimbursement |from |the |payer.
Documentation |must |reflect |MDM!
evaluation |and |management |(E&M)
14. Correctly |order |the |E&M |office |visit |codes |based |on |complexity |from |least |to |most
|complex
New |patient: Established |patient:
1. Minimal/RN |visit: |99201 Minimal |RN |visit: |99211
2. Problem |focused: |99202 Problem |focused: |99212
3. Expanded |problem |focused: |99203 Expanded |problem |focused: |99213
4. Detailed: |99204 Detailed: |99214
5. Comprehensive: |99205 Comprehensive: |99215
15. Discuss |a |minimum |of |three |purposes |of |the |written |history |and |physical |in
|relation |to |the |importance |of |documentation
Important |reference |document |that |gives |concise |info |about |the |pt's |Hx |and |exam
|findings.
Outlines |a |plan |for |addressing |issues |that |prompted |the |visit. |Info |should |be
|presented |in |a |logical |fashion |that |prominently |features |all |data |relevant |to |the |pt's
|condition.
Is |a |means |of |communicating |info |to |all |providers |involved |in |the |pt's |care.
3
, NR |511 |– |FINAL |EXAM |STUDY
|GUIDE
Is |a |medical-legal |document.
Is |essential |in |order |to |accurately |code |and |bill |for |services.
16. Accurately |document |why |every |procedure |code |must |have |a |corresponding
|diagnosis |code
Diagnosis |code |explains |the |necessity |of |the |procedure |code.
|Insurance |won't |pay |if |they |don't |correspond.
17. Correctly |identify |a |patient |as |new |or |established |given |the |historical |information |If
|that |pt |has |never |been |seen |in |that |clinic |or |by |that |group |of |providers |OR |if |the |pt
|has |not |been |seen |in |the |past |3 |years.
18. Identify |the |3 |components |required |in |determining |an |outpatient, |office |visit |E&M
|code
Place |of |service
|Type |of |service
|Patient |status
19. Describe |the |components |of |Medical |Decision |Making |in |E&M |coding
Risk
|Data
Diagnosis
The |more |time |and |consideration |involved |in |dealing |with |a |pt, |the |higher |the
|reimbursement |from |the |payer.
Documentation |must |reflect |MDM!
evaluation |and |management |(E&M)
20. Explain |what |a |“well |rounded” |clinical |experience |means
Includes |seeing |kids |from |birth |through |young |adult |visits |for |well |child |and |acute |visits, |as
|well |as |adults |for |wellness |or |acute/routine |visits.
Seeing |a |variety |of |pt's, |including |15% |of |peds |and |15% |of |women's |health |of |total |time |in
|the |program.
21. State |the |maximum |number |of |hours |that |time |can |be |spent |“rounding” |in |a
|facility
No |more |than |25% |of |total |practicum |hours |in |the |program
22. State |9 |things |that |must |be |documented |when |inputting |data |into |clinical
|encounter
Date |of |service
|Age
Gender |and |ethnicity
|Visit |E&M |code
CC
Procedures
Tests |performed |and |ordered
4
