POFM1332 WK 1 TEST EXAM QUESTIONS AND ANSWERS
A coder acquires a working knowledge of coding systems, coding conventions and guidelines,
government regulations, and third-party payer requirements to ensure that documented diagnoses,
services, and procedures are coded accurately for __________, research, and statistical purposes. -
CORRECT ANSWER✅✅reimbursement
A coding compliance program ensures that the assignment of codes to diagnoses, procedures, and
services follows established coding guidelines, and health care organizations write policies and
procedures to assist in implementing the coding compliance stages of __________. - CORRECT
ANSWER✅✅detection, correction, prevention, verification, and comparison
Adopting HIPAA's standard code sets has improved data quality and simplified claims submission for
health care providers who routinely deal with multiple __________. - CORRECT ANSWER✅✅health
plans
A hospitalist is a physician whose practice emphasizes providing care for hospital __________, and they
are often internal medicine specialists who handle a patient's entire admission process. - CORRECT
ANSWER✅✅inpatients
An effective coding compliance program monitors coding processes for __________. - CORRECT
ANSWER✅✅completeness, reliability, validity, and timeliness
A patient record is the business record for a patient encounter that documents __________. - CORRECT
ANSWER✅✅health care services provided to a patient
A physician lists "viral pneumonia" as the final diagnosis. However, the coder notes that laboratory
results state "gram-negative bacteria." There is also documentation of chest pain, fever, and dyspnea
due to pneumonia. What should the coder do? - CORRECT ANSWER✅✅Query the physician regarding
the diagnosis of pneumonia
A secondary purpose of the patient record is to __________. - CORRECT ANSWER✅✅evaluate patient
quality of care
, A teaching hospital is engaged in an approved graduate medical education __________ program in
medicine, osteopathy, dentistry, or podiatry. - CORRECT ANSWER✅✅residency
A third-party administrator (TPA) is an entity that __________ and may contract with a health care
clearinghouse to standardize data for claims processing. - CORRECT ANSWER✅✅processes health care
claims and performs related business functions for a health plan
Automated case abstracting software is used by hospitals to __________. - CORRECT
ANSWER✅✅collect data for statistical analysis
Chief complaint, social data, and past medical history are considered part of the problemoriented record
__________. - CORRECT ANSWER✅✅database
Coders also have the opportunity to work at home for employers who partner with an Internet-based
organization called a(n) __________, which is a third-party entity that manages and distributes
software-based services and solutions to customers using the Internet. - CORRECT
ANSWER✅✅application service provider (ASP)
Coders are prohibited from performing assumption coding, which is the assignment of codes based on
assuming, from a review of clinical evidence in the patient's record, that the patient has certain
diagnoses or received certain procedures/services even though the __________. - CORRECT
ANSWER✅✅provider did not specifically document those diagnoses or procedures and services
Coding is the assignment of codes to diagnoses, services, and procedures based on __________. -
CORRECT ANSWER✅✅patient record documentation
Computer-assisted coding uses software to automatically generate __________ by "reading" transcribed
clinical documentation provided by health care practitioners. - CORRECT ANSWER✅✅medical codes
Concurrent coding is the review of records and/or use of encounter forms and chargemasters to assign
codes __________. - CORRECT ANSWER✅✅during an inpatient stay or outpatient encounter
A coder acquires a working knowledge of coding systems, coding conventions and guidelines,
government regulations, and third-party payer requirements to ensure that documented diagnoses,
services, and procedures are coded accurately for __________, research, and statistical purposes. -
CORRECT ANSWER✅✅reimbursement
A coding compliance program ensures that the assignment of codes to diagnoses, procedures, and
services follows established coding guidelines, and health care organizations write policies and
procedures to assist in implementing the coding compliance stages of __________. - CORRECT
ANSWER✅✅detection, correction, prevention, verification, and comparison
Adopting HIPAA's standard code sets has improved data quality and simplified claims submission for
health care providers who routinely deal with multiple __________. - CORRECT ANSWER✅✅health
plans
A hospitalist is a physician whose practice emphasizes providing care for hospital __________, and they
are often internal medicine specialists who handle a patient's entire admission process. - CORRECT
ANSWER✅✅inpatients
An effective coding compliance program monitors coding processes for __________. - CORRECT
ANSWER✅✅completeness, reliability, validity, and timeliness
A patient record is the business record for a patient encounter that documents __________. - CORRECT
ANSWER✅✅health care services provided to a patient
A physician lists "viral pneumonia" as the final diagnosis. However, the coder notes that laboratory
results state "gram-negative bacteria." There is also documentation of chest pain, fever, and dyspnea
due to pneumonia. What should the coder do? - CORRECT ANSWER✅✅Query the physician regarding
the diagnosis of pneumonia
A secondary purpose of the patient record is to __________. - CORRECT ANSWER✅✅evaluate patient
quality of care
, A teaching hospital is engaged in an approved graduate medical education __________ program in
medicine, osteopathy, dentistry, or podiatry. - CORRECT ANSWER✅✅residency
A third-party administrator (TPA) is an entity that __________ and may contract with a health care
clearinghouse to standardize data for claims processing. - CORRECT ANSWER✅✅processes health care
claims and performs related business functions for a health plan
Automated case abstracting software is used by hospitals to __________. - CORRECT
ANSWER✅✅collect data for statistical analysis
Chief complaint, social data, and past medical history are considered part of the problemoriented record
__________. - CORRECT ANSWER✅✅database
Coders also have the opportunity to work at home for employers who partner with an Internet-based
organization called a(n) __________, which is a third-party entity that manages and distributes
software-based services and solutions to customers using the Internet. - CORRECT
ANSWER✅✅application service provider (ASP)
Coders are prohibited from performing assumption coding, which is the assignment of codes based on
assuming, from a review of clinical evidence in the patient's record, that the patient has certain
diagnoses or received certain procedures/services even though the __________. - CORRECT
ANSWER✅✅provider did not specifically document those diagnoses or procedures and services
Coding is the assignment of codes to diagnoses, services, and procedures based on __________. -
CORRECT ANSWER✅✅patient record documentation
Computer-assisted coding uses software to automatically generate __________ by "reading" transcribed
clinical documentation provided by health care practitioners. - CORRECT ANSWER✅✅medical codes
Concurrent coding is the review of records and/or use of encounter forms and chargemasters to assign
codes __________. - CORRECT ANSWER✅✅during an inpatient stay or outpatient encounter
