Ahima CCS-P questions and answers

physician's office can improve their copayment collections and increase revenue by using an electronic health record to assist them in: Benefits and eligibility checking Under RBRVS, all of the following are separate relative value units (RVUs) assigned for each CPT/HCPCS code, except for: Geographic practice cost indices: Each of the three RVUs is adjusted through the GPCIs to adjust for costs in different areas of the country. GPCIs are not relative value units The clinical documentation integrity (CDI) performance measure that indicates the number of times a physician responds to a CDI intervention divided by the number of CDI interventions issued is the: Physician response to CDI specialist rate: The physician response rate is how long it takes for a physician to respond to a CDI query. The physician clarification rate is the number of clarifications placed by a CDI intervention that had an impact on the code and the physician agreement with CDI specialist rate is the number of times a physician agrees with a CDI intervention divided by the number of CDI interventions issued A measure that assesses the ability to comply with billing edits is the: Clean claim rate: The clean claim rate assesses the ability to comply with billing edits. The denial rate is the measure that assesses the ability to comply with documentation, coding, and billing requirements. The PEPPER metric is used to identify billing patterns different from the majority of other providers in the nation. The capture rate is the metric used to identify coding of secondary diagnoses The physician has ordered an esophagogastroduodenoscopy (43235) for his patient. Which of the following ICD-10-CM codes would most likely justify the medical necessity of the examination? K26.3, Acute duodenal ulcer without hemorrhage or perforation What is the purpose of linking on a physician claim? Explain medical necessity of a procedure Which of the following is considered a nonfacility setting in relation to the RBRVS (Resource-based Relative Value Scale)? Dialysis center In RBRVS, this is an across-the-board national multiplier that is determined by CMS each year. It is the dollar amount that converts the relative value units into a payment amount: Conversion factor: The conversion factor is an across-the-board multiplier that is determined each year. It transforms the total of the RVUs into a payment amount A metric used to identify coding of secondary diagnoses is the: Capture rate: The denial rate is the measure that assesses the ability to comply with documentation, coding and billing requirements. The PEPPER metric is used to identify billing patterns different from the majority of other providers in the nation. The capture rate is the metric used to identify coding of secondary diagnoses. The clean claim rate assesses the ability to comply with billing edits A coding manager reviewed the following information before the claim was submitted. What change would be required to ensure proper payment? John Doe 30300 Removal foreign body, intranasal; office type procedure H44.701 Unspecified retained (old) intraocular foreign body, nonmagnetic, right eye The diagnosis must be correctly linked to the procedure.