ACMA CERTIFICATION UPDATED FINAL EXAM
QUESTIONS AND ANSWERS SURE A+
✔✔Condition Code 44 (CC44) - ✔✔Code describing a change in status when specific
criteria are met. When patient changed from inpatient to observation prior to patient
discharge when specific criteria are met
✔✔Conditions of Participation - ✔✔Sections of the Code of Federal Regulations that
pertain to health and safety standards that healthcare organizations must meet in order
to begin and continue participating in the Medicare and Medicaid programs
✔✔Continued Stay Reviews - ✔✔Ongoing assessment of a patient's progress through
review and evaluation of the physician documentation performed to determine whether
continues to stay should occur within the level of care in which the patient was initially
placed or if a move to another level of care or to discharge is required
✔✔Core measures - ✔✔Group of evidence based indicators that when met result in
improved clinical outcomes for patients, decreased mortality rate and reduced
healthcare cost
✔✔Detailed Notice of Discharge (DND notice) - ✔✔Provide a full explanation of the
reasons for a hospital discharge and/or why services received are no longer covered by
Medicare to a patient or their representative
, ✔✔Diagnosis-related groups (DRGs) - ✔✔Patient classification system used to identify
resources expended for hospital services without taking into account the therapeutic
approaches employed. Patient records categorized into homogenous groups according
to dx and healthcare expenses involved based on average LOS, pt load, comparative
performance index, and case mix index
✔✔Durable Medical Equipment (DME) - ✔✔Medical equipment used in the home to aid
in provide a better quality of living
✔✔Emergency Medical Treatment and Active Labor Act (EMTALA) - ✔✔Requires
hospitals to provide an examination as well as needed stabilizing treatment without
consideration of insurance coverage or ability to pay when a patient presents to an ER
for an emergency medical condition
✔✔Extended Stay/Recovery - ✔✔Terminology used for outpatients in a bed who do not
meet either inpatient or observation status requirements. Ex. Pts boarding after
uncomplicated procedure or social admissions - room and board not billable
✔✔Health Information Portability and accountability act of 1996 (HIPAA) - ✔✔Privacy
rule standards that address the use and disclosure of individuals health information
called PHI by organizations (covered entities) as well as the standards for individuals
privacy rights to understand and control how health information is used
✔✔Health Literacy - ✔✔Degree to which individuals have the capacity to obtain,
process, and understand basic health information needed to make appropriate health
decisions and choose services needed to prevent or treat illness
✔✔Home Healthcare (HHC) - ✔✔Includes skilled services that can be given in the
home for an illness or injury for example RN/PT/OT/SW/HHA that is usually less
expensive, more convenient and just as effective as care received in a hospital or SNF
✔✔Home Medical Equipment (HME) - ✔✔Category of devices used for patients whose
care is being managed from a home or other private facility managed by a
nonprofessional caregiver or family member.
✔✔Hospice - ✔✔Service offering comfort care for the dying when medical treatment is
no longer expected to cure the disease or prolong life
Insurance benefit that pays the cost of comfort care for patients with a prognosis of 6
months or less to live
✔✔Hospital acquired conditions - ✔✔Undesirable situation or condition that affects a
patient and that arose during a stay in a hospital or medical facility. Also a designation
used by CMS for reimbursement purposes
QUESTIONS AND ANSWERS SURE A+
✔✔Condition Code 44 (CC44) - ✔✔Code describing a change in status when specific
criteria are met. When patient changed from inpatient to observation prior to patient
discharge when specific criteria are met
✔✔Conditions of Participation - ✔✔Sections of the Code of Federal Regulations that
pertain to health and safety standards that healthcare organizations must meet in order
to begin and continue participating in the Medicare and Medicaid programs
✔✔Continued Stay Reviews - ✔✔Ongoing assessment of a patient's progress through
review and evaluation of the physician documentation performed to determine whether
continues to stay should occur within the level of care in which the patient was initially
placed or if a move to another level of care or to discharge is required
✔✔Core measures - ✔✔Group of evidence based indicators that when met result in
improved clinical outcomes for patients, decreased mortality rate and reduced
healthcare cost
✔✔Detailed Notice of Discharge (DND notice) - ✔✔Provide a full explanation of the
reasons for a hospital discharge and/or why services received are no longer covered by
Medicare to a patient or their representative
, ✔✔Diagnosis-related groups (DRGs) - ✔✔Patient classification system used to identify
resources expended for hospital services without taking into account the therapeutic
approaches employed. Patient records categorized into homogenous groups according
to dx and healthcare expenses involved based on average LOS, pt load, comparative
performance index, and case mix index
✔✔Durable Medical Equipment (DME) - ✔✔Medical equipment used in the home to aid
in provide a better quality of living
✔✔Emergency Medical Treatment and Active Labor Act (EMTALA) - ✔✔Requires
hospitals to provide an examination as well as needed stabilizing treatment without
consideration of insurance coverage or ability to pay when a patient presents to an ER
for an emergency medical condition
✔✔Extended Stay/Recovery - ✔✔Terminology used for outpatients in a bed who do not
meet either inpatient or observation status requirements. Ex. Pts boarding after
uncomplicated procedure or social admissions - room and board not billable
✔✔Health Information Portability and accountability act of 1996 (HIPAA) - ✔✔Privacy
rule standards that address the use and disclosure of individuals health information
called PHI by organizations (covered entities) as well as the standards for individuals
privacy rights to understand and control how health information is used
✔✔Health Literacy - ✔✔Degree to which individuals have the capacity to obtain,
process, and understand basic health information needed to make appropriate health
decisions and choose services needed to prevent or treat illness
✔✔Home Healthcare (HHC) - ✔✔Includes skilled services that can be given in the
home for an illness or injury for example RN/PT/OT/SW/HHA that is usually less
expensive, more convenient and just as effective as care received in a hospital or SNF
✔✔Home Medical Equipment (HME) - ✔✔Category of devices used for patients whose
care is being managed from a home or other private facility managed by a
nonprofessional caregiver or family member.
✔✔Hospice - ✔✔Service offering comfort care for the dying when medical treatment is
no longer expected to cure the disease or prolong life
Insurance benefit that pays the cost of comfort care for patients with a prognosis of 6
months or less to live
✔✔Hospital acquired conditions - ✔✔Undesirable situation or condition that affects a
patient and that arose during a stay in a hospital or medical facility. Also a designation
used by CMS for reimbursement purposes
