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Exam (elaborations)

CCS EXAM PREP-DOMAIN 8/COMPLIANCE 100% CORRECT

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CCS EXAM PREP-DOMAIN 8/COMPLIANCE 100% CORRECT A female patient is admitted for a second-degree cystocele. A repair is performed. In order to code this accurately, what document provided the required additional information? Operative report In order to accurately code a catheterization, what needs to be determined based on a review of documentation? The approach, the side of the heart(chambers) into which the catheter was inserted , as well as any additional procedures performed. A 70 year old patient has congestive heart failure and hypertension with end-stage renal disease. What should the codes be? I13.2, Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease, I50.9, Heart failure, unspecified, and N18.6 End stage renal disease. A 35 year old woman has hypertension with acute renal failure and stage 3 chronic kidney disease. What code would be assigned? N17.9, Acute kidney failure, unspecified and I12.9, Hypertensive chronic kidney disease with stage I through stage 4 chronic kidney disease, or unspecified chronic kidney disease and N18.3, Chronic kidney disease, stage 3(moderate) A 55 year old patient has hypertensive heart disease with congestive heart failure. What codes would be assigned? I11.0, Hypertensive heart disease with heart failure and I50.9, Heart failure, unspecified (There is a cause and effect relationship between the hypertension and the congestive heart failure. A separate code for the congestive heart failure is assigned based on the "code also" note) The CPT definition of a surgical package contains which of the following? The surgical procedures CPT defines a separate procedure as which of the following? When performed in conjunction with another service, is considered an integral part of the major service To accurately code wound closures, what questions need to be answered? What type of repair was undertaken: simple, intermediate, or complex and the site or body part involved, and the extent of the wound Coding compliance policies should include: Facility specific documentation requirements Under HIPAA Standards for Code Sets, the sets of codes used to encode the diagnoses and procedures, data elements, and medical concepts must be used in: Electronic transactions only A 75 year old woman is admitted to the hospital after tripping and falling at home. She underwent an open reduction with internal fixation of the femur. Which of the following would be important to capture in addition to the diagnostic codes? External cause codes for Cause of Injury, Place of Occurrence, activity and Status The actual payment the hospital is reimbursed is potentially based on which of the following? Hospital base rate, discharge disposition, adjustment for low-income patients, approved teaching hospital, and sole community hospital Quality improvement organizations (QIOs) are responsible to which of the following? Utilization Reviews for hospital requested higher weighted DRG payments and quality of care reviews due to complaints Medicare medical necessity is defined by which factors? Items and services that are reasonable and necessary for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category) According to Medicare requirements, a history and physical must: Be completed for each patient no more than 30 days before or 34 hours after admission or registration, but prior to surgery

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December 17, 2023
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2023/2024
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