CDIP Domain 6: Compliance ACTUAL
QUESTIONS AND CORRECT ANSWERS
Who sets the official Guidelines for coding and reporting (ICD-10)? -
CORRECT ANSWERS American Hospital Associates (AHA)
American Health information management association (AHIMA)
National Center for Health Statistics (NCHS)
Center for Medicare and Medicaid Services (CMS)
AHA - CORRECT ANSWERS Serves as a clearing house for issues
related to use of ICD-10 codes
services in representation and advocacy role on national classification and data
issues
publisher of the AHA coding Clinic (updated quarterly
AHIMA - CORRECT ANSWERS serves as a nonprofit association of
health information professionals
takes a lead in advancing health data and information management provides
multiple resources
NCHS - CORRECT ANSWERS serves as World Health Organization
(WHO) collaboration center for family of international classification of North
America
coordinates all official disease classifications activities in the US
CMS - CORRECT ANSWERS part of the US department of Health and
Human Services (HHS)
administers medicare and medicaid programs
compares websites for healthcare data
, HAC - CORRECT ANSWERS Hospital Acquired Conditions
PSI - CORRECT ANSWERS patient safety indicator
Fraud and abuse - CORRECT ANSWERS The intentional and mistaken
misrepresentation of reimbursement claims submitted to government-sponsored
health programs
Federal False Claims Act - CORRECT ANSWERS makes it an offense to
submit a false claim to the government for payment of health care services
Patient Protection and Affordable Care Act - CORRECT ANSWERS
health care reform law passed in 2010 that includes incentives and
penalties for employers providing health insurance as a benefit
Title XI of the social security activities - CORRECT ANSWERS
exclusion from the federal payer program if convicted of misconduct
Compliance - CORRECT ANSWERS the tendency to agree to do things
requested by others
HIPAA - CORRECT ANSWERS The Health Insurance Portability and
Accountability Act, a federal law protecting the privacy of patient-specific
health care information and providing the patient with control over how this
information is used and distributed. - 1996
DOJ - CORRECT ANSWERS Department of Justice; one of the entities,
along with the Office of Inspector General (OIG), that coordinates fraud and
abuse control.
QUESTIONS AND CORRECT ANSWERS
Who sets the official Guidelines for coding and reporting (ICD-10)? -
CORRECT ANSWERS American Hospital Associates (AHA)
American Health information management association (AHIMA)
National Center for Health Statistics (NCHS)
Center for Medicare and Medicaid Services (CMS)
AHA - CORRECT ANSWERS Serves as a clearing house for issues
related to use of ICD-10 codes
services in representation and advocacy role on national classification and data
issues
publisher of the AHA coding Clinic (updated quarterly
AHIMA - CORRECT ANSWERS serves as a nonprofit association of
health information professionals
takes a lead in advancing health data and information management provides
multiple resources
NCHS - CORRECT ANSWERS serves as World Health Organization
(WHO) collaboration center for family of international classification of North
America
coordinates all official disease classifications activities in the US
CMS - CORRECT ANSWERS part of the US department of Health and
Human Services (HHS)
administers medicare and medicaid programs
compares websites for healthcare data
, HAC - CORRECT ANSWERS Hospital Acquired Conditions
PSI - CORRECT ANSWERS patient safety indicator
Fraud and abuse - CORRECT ANSWERS The intentional and mistaken
misrepresentation of reimbursement claims submitted to government-sponsored
health programs
Federal False Claims Act - CORRECT ANSWERS makes it an offense to
submit a false claim to the government for payment of health care services
Patient Protection and Affordable Care Act - CORRECT ANSWERS
health care reform law passed in 2010 that includes incentives and
penalties for employers providing health insurance as a benefit
Title XI of the social security activities - CORRECT ANSWERS
exclusion from the federal payer program if convicted of misconduct
Compliance - CORRECT ANSWERS the tendency to agree to do things
requested by others
HIPAA - CORRECT ANSWERS The Health Insurance Portability and
Accountability Act, a federal law protecting the privacy of patient-specific
health care information and providing the patient with control over how this
information is used and distributed. - 1996
DOJ - CORRECT ANSWERS Department of Justice; one of the entities,
along with the Office of Inspector General (OIG), that coordinates fraud and
abuse control.
