CDIP ACTUAL FINALS QUESTIONS AND ANSWERS
SET A+
Case Mix Index (CMI) - ✔✔The average DRG relative weight for all Medicare
admissions.
Case/Care Management - ✔✔1. A process used by a doctor, nurse, or other healthcare
professional to manage a patient's healthcare. 2. The ongoing, concurrent review
performed by clinical professionals to ensure the necessity and effectiveness of the
clinical services being provided to a patient.
Chain of Command - ✔✔A hierarchical reporting structure within an organization.
Chargemaster/Charge Description Master (CDM) - ✔✔A financial management form
that contains information about the organization's charges for the healthcare services it
provides to patients.
Chief Complaint - ✔✔The principal problem a patient reports to a healthcare provider.
Clinical Validation - ✔✔The process of validating each diagnosis or procedure
documented within the health record, ensuring it is supported by clinical evidence.
Coding Clinic for HCPCS - ✔✔A publication issued quarterly by the American Hospital
Association and approved by the Centers for Medicare and Medicaid Services to give
coding advice and direction for HCPCS code assignment.
Coding Clinic for ICD-10-CM/PCS - ✔✔A publication issued quarterly by the American
Hospital Association and approved by the Centers for Medicare and Medicaid Services
to give coding advice and direction for ICD-10-CM/PCS.
, Colons - ✔✔In ICD-10-Cm colons (:) are used in the Tabular List after an incomplete
term which needs one or more of the modifiers following the colon to make it assignable
to a given category.
Comorbidity - ✔✔A pre-existing condition which because of its presence with the
principal diagnosis will increase the LOS by at least one day in 75% of the cases.
Complex Repair (Closure) - ✔✔Closure of a wound that requires a single layer closure
of the skin and superficial subcutaneous layers (simple repair), a layered closure of the
subcutaneous and/or superficial fascia layers (Intermediate repair), and at least one of
the following: exposure of bone, cartilage, tendon or neurovascular structure; extensive
undermining; placement of retention sutures; debridement of the wound edges.
Compliance - ✔✔1. The process of establishing an organizational culture that promotes
the prevention, detection, and resolution of instances of conduct that do not conform to
federal, state, or private payer healthcare program requirements or the healthcare
organization's ethical and business policies. 2. The act of adhering to official
requirements. 3. Managing a coding or billing department according to the laws,
regulations, and guidelines that govern it.
Complication - ✔✔A condition arising during the hospital stay that prolongs the length of
stay (LOS) by at least one day in approximately 75% of the cases.
Composite Performance Score (CPS) - ✔✔Used by the Merit Based Incentive Payment
System (MIPS) to determine reimbursement to providers based on their performance in
four weighted categories: Quality (30%), Cost (30%); Promoting Interoperability (25%);
and Improvement Activities (15%).
Comprehensive Error Rate Testing (CERT) Program - ✔✔Implemented by CMS to
measure improper payments in the Medicare Fee-for-Service (FFS) program.
Confidentiality - ✔✔1. A legal and ethical concept that establishes the healthcare
provider's responsibility for protecting health records and other personal and private
information from unauthorized use or disclosure. 2. As amended by HITECH, the
practice that data or information is not made available or disclosed to unauthorized
persons or processes.
Core Measures/Core Measure Set - ✔✔Standardized performance measures
developed to improve the safety and quality of healthcare.
Data Analysis - ✔✔A body of methods that help describe facts, detects patterns,
develop explanations, and test hypotheses.
SET A+
Case Mix Index (CMI) - ✔✔The average DRG relative weight for all Medicare
admissions.
Case/Care Management - ✔✔1. A process used by a doctor, nurse, or other healthcare
professional to manage a patient's healthcare. 2. The ongoing, concurrent review
performed by clinical professionals to ensure the necessity and effectiveness of the
clinical services being provided to a patient.
Chain of Command - ✔✔A hierarchical reporting structure within an organization.
Chargemaster/Charge Description Master (CDM) - ✔✔A financial management form
that contains information about the organization's charges for the healthcare services it
provides to patients.
Chief Complaint - ✔✔The principal problem a patient reports to a healthcare provider.
Clinical Validation - ✔✔The process of validating each diagnosis or procedure
documented within the health record, ensuring it is supported by clinical evidence.
Coding Clinic for HCPCS - ✔✔A publication issued quarterly by the American Hospital
Association and approved by the Centers for Medicare and Medicaid Services to give
coding advice and direction for HCPCS code assignment.
Coding Clinic for ICD-10-CM/PCS - ✔✔A publication issued quarterly by the American
Hospital Association and approved by the Centers for Medicare and Medicaid Services
to give coding advice and direction for ICD-10-CM/PCS.
, Colons - ✔✔In ICD-10-Cm colons (:) are used in the Tabular List after an incomplete
term which needs one or more of the modifiers following the colon to make it assignable
to a given category.
Comorbidity - ✔✔A pre-existing condition which because of its presence with the
principal diagnosis will increase the LOS by at least one day in 75% of the cases.
Complex Repair (Closure) - ✔✔Closure of a wound that requires a single layer closure
of the skin and superficial subcutaneous layers (simple repair), a layered closure of the
subcutaneous and/or superficial fascia layers (Intermediate repair), and at least one of
the following: exposure of bone, cartilage, tendon or neurovascular structure; extensive
undermining; placement of retention sutures; debridement of the wound edges.
Compliance - ✔✔1. The process of establishing an organizational culture that promotes
the prevention, detection, and resolution of instances of conduct that do not conform to
federal, state, or private payer healthcare program requirements or the healthcare
organization's ethical and business policies. 2. The act of adhering to official
requirements. 3. Managing a coding or billing department according to the laws,
regulations, and guidelines that govern it.
Complication - ✔✔A condition arising during the hospital stay that prolongs the length of
stay (LOS) by at least one day in approximately 75% of the cases.
Composite Performance Score (CPS) - ✔✔Used by the Merit Based Incentive Payment
System (MIPS) to determine reimbursement to providers based on their performance in
four weighted categories: Quality (30%), Cost (30%); Promoting Interoperability (25%);
and Improvement Activities (15%).
Comprehensive Error Rate Testing (CERT) Program - ✔✔Implemented by CMS to
measure improper payments in the Medicare Fee-for-Service (FFS) program.
Confidentiality - ✔✔1. A legal and ethical concept that establishes the healthcare
provider's responsibility for protecting health records and other personal and private
information from unauthorized use or disclosure. 2. As amended by HITECH, the
practice that data or information is not made available or disclosed to unauthorized
persons or processes.
Core Measures/Core Measure Set - ✔✔Standardized performance measures
developed to improve the safety and quality of healthcare.
Data Analysis - ✔✔A body of methods that help describe facts, detects patterns,
develop explanations, and test hypotheses.
