Which medicare part is reimbursed based on the risk adjustment models
Correct answer
Part c
Who typically employs risk adjustment coders
Correct answer
Health plans
Is a health plan required to follow the minimum necessary rule
Correct answer
Yes, health plans are covered entities and are therefore required to follow the minimum
necessary rule
What is an example of fraud
Correct answer
Reporting a diagnosis or co-morbidity that does not exist to obtain higher reimbursement
Which part of medicare is also called medicare advantage
1
@https://www.stuvia.com/user/thestudyvault
,Correct answer
Part c
Which health insurance assistance program is sponsored by federal and state governments
Correct answer
Medicaid
What oig document should a medicare advantage participant review for potential problem
areas that will receive special scrutiny in the upcoming year
Correct answer
Oig work plan
Which code set is used by risk adjustment coders
Correct answer
Icd-10-cm
Which regulation strengthens hipaa rules by addressing privacy and security concerns
associated with the electronic transmission of health information
Correct answer
Health information technology for economic and clinical health act (hitech)
What is coding
Correct answer
2
@https://www.stuvia.com/user/thestudyvault
,Translating a written or dictated medical record into a series of alphanumeric codes
Which organ is in the thoracic cavity
Correct answer
Lungs
What does the term distal indicate
Correct answer
Farther from the point of attachment
Blood is received back into the left atrium of the heart through....
Correct answer
Pulmonary veins
The root of the nail is also known as what
Correct answer
Germinal matrix
The documentation states: past surgical history: she had a lumpectomy of the breast for dcis
12 years ago which successfully eradicated the ca
How would this be reported
Correct answer
3
@https://www.stuvia.com/user/thestudyvault
, Personal history of breast cancer
The documentation states: soft druse, some calcified
What system would have this documentation
Correct answer
Ocular
Which organ does pulmonary refer to
Correct answer
Lungs
What is a peg tube
Correct answer
A tube inserted into the stomach for long term feeding
Angina pectoris refers to which system
Correct answer
Cardiovascular
What is cholelithiasis
Correct answer
4
@https://www.stuvia.com/user/thestudyvault
Correct answer
Part c
Who typically employs risk adjustment coders
Correct answer
Health plans
Is a health plan required to follow the minimum necessary rule
Correct answer
Yes, health plans are covered entities and are therefore required to follow the minimum
necessary rule
What is an example of fraud
Correct answer
Reporting a diagnosis or co-morbidity that does not exist to obtain higher reimbursement
Which part of medicare is also called medicare advantage
1
@https://www.stuvia.com/user/thestudyvault
,Correct answer
Part c
Which health insurance assistance program is sponsored by federal and state governments
Correct answer
Medicaid
What oig document should a medicare advantage participant review for potential problem
areas that will receive special scrutiny in the upcoming year
Correct answer
Oig work plan
Which code set is used by risk adjustment coders
Correct answer
Icd-10-cm
Which regulation strengthens hipaa rules by addressing privacy and security concerns
associated with the electronic transmission of health information
Correct answer
Health information technology for economic and clinical health act (hitech)
What is coding
Correct answer
2
@https://www.stuvia.com/user/thestudyvault
,Translating a written or dictated medical record into a series of alphanumeric codes
Which organ is in the thoracic cavity
Correct answer
Lungs
What does the term distal indicate
Correct answer
Farther from the point of attachment
Blood is received back into the left atrium of the heart through....
Correct answer
Pulmonary veins
The root of the nail is also known as what
Correct answer
Germinal matrix
The documentation states: past surgical history: she had a lumpectomy of the breast for dcis
12 years ago which successfully eradicated the ca
How would this be reported
Correct answer
3
@https://www.stuvia.com/user/thestudyvault
, Personal history of breast cancer
The documentation states: soft druse, some calcified
What system would have this documentation
Correct answer
Ocular
Which organ does pulmonary refer to
Correct answer
Lungs
What is a peg tube
Correct answer
A tube inserted into the stomach for long term feeding
Angina pectoris refers to which system
Correct answer
Cardiovascular
What is cholelithiasis
Correct answer
4
@https://www.stuvia.com/user/thestudyvault