When a POA indicator for a HAC that is the only CC/MCC condition on the record is
listed as N, what happens to the reimbursement for that account?
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, The reimbursement goes down since the condition was not present on
admission and could/ should have been prevented using best practices
After a patient is discharged from the hospital, the medical record must be reviewed for
what?
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H&P and discharge summary
The same provider, for same beneficiary, on same date of service
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National Correct Coding Initiative (NCCI) Edits apply to services billed by
What?
If a patient undergoes an inpatient procedure and the final summary diagnosis is different
from the diagnosis on the pathology report, the coder should
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Query the attending physician as to the final diagnosis
, A patient was admitted with heart failure within one week of a heart transplant. Due to
the timing, the coder thought the heart failure may indicate a transplant rejection.. What
action(s) should the coding staff take?
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Query the physician.
-Sex and procedure edits
-Invalid revenue code edits
-Diagnosis and age edits
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What are types of edits found the OCE (Outpatient code editor)?
When a patient goes home with an order for home health to start one week after an
inpatient admission, this is categorized as a(n
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Discharge
What is the term used for applying the HIPAA privacy rule over state rule(s) which are
less strict?
listed as N, what happens to the reimbursement for that account?
Give this one a try later!
, The reimbursement goes down since the condition was not present on
admission and could/ should have been prevented using best practices
After a patient is discharged from the hospital, the medical record must be reviewed for
what?
Give this one a try later!
H&P and discharge summary
The same provider, for same beneficiary, on same date of service
Give this one a try later!
National Correct Coding Initiative (NCCI) Edits apply to services billed by
What?
If a patient undergoes an inpatient procedure and the final summary diagnosis is different
from the diagnosis on the pathology report, the coder should
Give this one a try later!
Query the attending physician as to the final diagnosis
, A patient was admitted with heart failure within one week of a heart transplant. Due to
the timing, the coder thought the heart failure may indicate a transplant rejection.. What
action(s) should the coding staff take?
Give this one a try later!
Query the physician.
-Sex and procedure edits
-Invalid revenue code edits
-Diagnosis and age edits
Give this one a try later!
What are types of edits found the OCE (Outpatient code editor)?
When a patient goes home with an order for home health to start one week after an
inpatient admission, this is categorized as a(n
Give this one a try later!
Discharge
What is the term used for applying the HIPAA privacy rule over state rule(s) which are
less strict?
