1. A physician's office can improve their
Benefits and eligibility checking
copay- ment collections and increase
revenue by us- ing an electronic health
record to assist them in:
2. Under RBRVS, all of the following are separate Geographic practice cost
indices: Each
relative value units (RVUs) assigned for of the three RVUs is adjusted through
each CPT/HCPCS code, except for: the GPCIs to adjust for costs in
ditter- ent areas of the country.
GPCIs are not relative value units
3. The clinical documentation integrity (CDI) per- Physician response to CDI
specialist
formance measure that indicates the rate: The physician response rate is
number of times a physician responds how long it takes for a
to a CDI inter- physician to
vention divided by the number of CDI interven- respond to a CDI query.
The physician
tions issued is the: clarification rate is the number of
clar- ifications placed by a CDI
intervention that had an impact
on the code and the physician
agreement with CDI spe- cialist
rate is the number of times a
physician agrees with a CDI
interven- tion divided by the
number of CDI in- terventions
4. A measure that assesses the ability to issued
comply with billing edits is the:
Clean claim rate: The clean claim
rate assesses the ability to
comply with billing edits. The
,Ahima CCS-P questions well answered graded A+
denial rate is the mea- sure that assesses the ability to com- ply
with documentation, coding, and billing requirements. The PEPPER
met- ric is used to identify billing patterns ditterent from the
majority of other
,Ahima CCS-P questions well answered graded A+
providers in the nation. The
capture rate is the metric used to
identify cod- ing of secondary
diagnoses
5. The physician has ordered an
esophagogas- troduodenoscopy K26.3, Acute duodenal ulcer without
(43235) for his patient. Which of the hemorrhage or perforation
following ICD-10-CM codes would most
likely justify the medical necessity of the
examination?
6. What is the purpose of linking on a Explain medical necessity of a
physician claim? proce- dure
7. Which of the following is considered a Dialysis center
non- facility setting in relation to the
RBRVS (Re- source-based Relative
Value Scale)?
Conversion factor: The conversion
8. In RBRVS, this is an across-the-board fac- tor is an across-the-board
nation- al multiplier that is determined multiplier that is determined each
by CMS each year. It is the dollar year. It trans- forms the total of the
amount that converts the relative RVUs into a pay- ment amount
value units into a payment amount:
Capture rate: The denial rate is
the measure that assesses the
9. A metric used to identify coding of ability to comply with
secondary diagnoses is the: documentation, coding and billing
requirements. The PEPPER metric
is used to identify billing pat-
terns ditterent from the majority of
oth- er providers in the nation. The
capture rate is the metric used to
, Ahima CCS-P questions well answered graded A+
identify cod- ing of secondary diagnoses. The clean