CDIP FINAL EXAM NEWEST VERSION - EXAMINATION
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1: For accurate reporting and payment of
hospital-acquired conditions, which of the following questions are
important?
A. Is there documented clinical evidence that the condition was
present during the hospitalization?
B. Is the condition present on admission?
C. Was the condition present at the time of discharge?
D. Both A and B
Answer:
D) Both A and B
Question 2: A patient presented to the ED with a fever and WBCs at
25,000. The patient was experiencing fatigue and altered metal
status and complaint of pain in the pelvic area. The patient also had
elevated blood sugar of 286, was thought to be in ketoacidosis, and
was subsequently admitted. The physician documented
catheter-associated UTI at discharge. Based on the physician
documentation, the CDS may want to query for?
A. UTI being present on admission
B. Type of organism
C. Uncontrolled diabetes
D. No query warranted
Answer:
A) UTI being present on admission
,Question 3: To determine whether inpatient admission is
reasonable and payable under Medicare Part A, this rule
established a Medicare payment policy regarding the benchmark
criteria of
A. Utilization rule
B. Short stay rule
C. Two midnight rule
D. 80/20 rule
Answer:
B) Short stay rule
Question 4: Due to the compliance concerns surrounding the
possible leading queries, CMA has engaged which organization to
assist in record review of certain DRGs and documentation
concerns
A. QIO
B. PEPPER
C. ONC
D. Q-Net
Answer:
A) QIO
Question 5: The QIO (Quality Improvement Organizations) Program,
one of the largest federal programs dedicated to improving health
quality for Medicare beneficiaries, is an integral part of the U.S.
Department of Health and Human (HHS) Services' National Quality
Strategy for providing better care and better health at lower cost.
By law, the mission of the QIO Program is to improve the
effectiveness, efficiency, economy, and quality of services
delivered to Medicare beneficiaries. Based on this statutory charge,
,and CMS's program experience, CMS identifies the core functions
of the QIO Program as: Improving quality of care for beneficiaries;
Protecting the integrity of the Medicare Trust Fund by ensuring that
Medicare pays only for services and goods that are reasonable and
necessary and that are provided in the most appropriate setting;
and Protecting beneficiaries by expeditiously addressing individual
complaints, such as beneficiary complaints; provider-based notice
appeals; violations of the Emergency Medical Treatment and Labor
Act (EMTALA); and other related responsibilities as articulated in
QIO-related law. This document outlines areas of audit review as
pursued by the Department of Health and Human Services by the
Office of Inspector General (OIG)
A. OIG Statement of Work
B. OIG Final Rule
C. OIG Work Plan
D. None of the above
Answer:
C) OIG Work Plan
Question 6: The OIG Work Plan outlines areas of audit and review
as pursued by the Department of Health and Human Services by
the Office of Inspector General (OIG). This document is published
and updated yearly. This government audit agency calculates the
national paid claims error rate for all of the Medicare fee-for-service
claims paid by MACs
A. Comprehensive Error Rate Testing (CERT)
B. Recovery Audit Contractor (RAC)
C. Medicare Administrative Contractor (MAC)
D. No governmental agency regulates error rate
Answer:
, A) Comprehensive Error Rate Testing (CERT)
Question 7: The CDS manager is implementing a process to review
queries ongoing for format and appropriateness. This should be
done:
A. Weekly
B. Monthly
C. Quarterly
D. Annually
Answer:
D) Annually
Question 8: In 1990, 3M created which DRG system that several
states use for Medicaid reimbursement and is also used by
facilities to analyze some portion of the data for Medicare Quality
Indicators. What is this system called?
A. MS-DRGs
B. AP-DRGs
C. APR-DRGs
D. CPT-DRGs
Answer:
C) APR-DRGs
Question 9: A patient has a prostate malignancy that had not been
excised, removed, and still under treatment. The patient presents to
the hospital with irregular heartbeat, malaise and gross hematuria
with large amounts of blood being passed bia the urethra with the
inability to urinate. Patient was noted to have a hemoglobin of 10.8
due to significant blood loss, the patient was transfused and
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1: For accurate reporting and payment of
hospital-acquired conditions, which of the following questions are
important?
A. Is there documented clinical evidence that the condition was
present during the hospitalization?
B. Is the condition present on admission?
C. Was the condition present at the time of discharge?
D. Both A and B
Answer:
D) Both A and B
Question 2: A patient presented to the ED with a fever and WBCs at
25,000. The patient was experiencing fatigue and altered metal
status and complaint of pain in the pelvic area. The patient also had
elevated blood sugar of 286, was thought to be in ketoacidosis, and
was subsequently admitted. The physician documented
catheter-associated UTI at discharge. Based on the physician
documentation, the CDS may want to query for?
A. UTI being present on admission
B. Type of organism
C. Uncontrolled diabetes
D. No query warranted
Answer:
A) UTI being present on admission
,Question 3: To determine whether inpatient admission is
reasonable and payable under Medicare Part A, this rule
established a Medicare payment policy regarding the benchmark
criteria of
A. Utilization rule
B. Short stay rule
C. Two midnight rule
D. 80/20 rule
Answer:
B) Short stay rule
Question 4: Due to the compliance concerns surrounding the
possible leading queries, CMA has engaged which organization to
assist in record review of certain DRGs and documentation
concerns
A. QIO
B. PEPPER
C. ONC
D. Q-Net
Answer:
A) QIO
Question 5: The QIO (Quality Improvement Organizations) Program,
one of the largest federal programs dedicated to improving health
quality for Medicare beneficiaries, is an integral part of the U.S.
Department of Health and Human (HHS) Services' National Quality
Strategy for providing better care and better health at lower cost.
By law, the mission of the QIO Program is to improve the
effectiveness, efficiency, economy, and quality of services
delivered to Medicare beneficiaries. Based on this statutory charge,
,and CMS's program experience, CMS identifies the core functions
of the QIO Program as: Improving quality of care for beneficiaries;
Protecting the integrity of the Medicare Trust Fund by ensuring that
Medicare pays only for services and goods that are reasonable and
necessary and that are provided in the most appropriate setting;
and Protecting beneficiaries by expeditiously addressing individual
complaints, such as beneficiary complaints; provider-based notice
appeals; violations of the Emergency Medical Treatment and Labor
Act (EMTALA); and other related responsibilities as articulated in
QIO-related law. This document outlines areas of audit review as
pursued by the Department of Health and Human Services by the
Office of Inspector General (OIG)
A. OIG Statement of Work
B. OIG Final Rule
C. OIG Work Plan
D. None of the above
Answer:
C) OIG Work Plan
Question 6: The OIG Work Plan outlines areas of audit and review
as pursued by the Department of Health and Human Services by
the Office of Inspector General (OIG). This document is published
and updated yearly. This government audit agency calculates the
national paid claims error rate for all of the Medicare fee-for-service
claims paid by MACs
A. Comprehensive Error Rate Testing (CERT)
B. Recovery Audit Contractor (RAC)
C. Medicare Administrative Contractor (MAC)
D. No governmental agency regulates error rate
Answer:
, A) Comprehensive Error Rate Testing (CERT)
Question 7: The CDS manager is implementing a process to review
queries ongoing for format and appropriateness. This should be
done:
A. Weekly
B. Monthly
C. Quarterly
D. Annually
Answer:
D) Annually
Question 8: In 1990, 3M created which DRG system that several
states use for Medicaid reimbursement and is also used by
facilities to analyze some portion of the data for Medicare Quality
Indicators. What is this system called?
A. MS-DRGs
B. AP-DRGs
C. APR-DRGs
D. CPT-DRGs
Answer:
C) APR-DRGs
Question 9: A patient has a prostate malignancy that had not been
excised, removed, and still under treatment. The patient presents to
the hospital with irregular heartbeat, malaise and gross hematuria
with large amounts of blood being passed bia the urethra with the
inability to urinate. Patient was noted to have a hemoglobin of 10.8
due to significant blood loss, the patient was transfused and
