HIT 235 MODULE 3 KNOWLEDGE CHECK EXAM
QUESTIONS AND ANSWERS GRADED A+
What is the estimated IPPS Medicare payment for the following
inpatient case?
Patient BB was treated for congestive heart failure. No operating room
surgical procedure was performed. MS-DRG 293 was assigned with a
relative weight (RW) of 0.6756. Length of patient stay: 3 days. Hospital
adjusted base rate: $7,350.00. ANS >> $4,965.66
Which prospective payment system rule or provision was applied in the
following case?
A patient was discharged from an inpatient psychiatric facility on
Sunday, then readmitted to another inpatient psychiatric facility on the
Tuesday following his discharge from the original facility. This was
considered one continuous stay for the purposes of payment. ANS >>
interrupted stay
, HIT 235 MODULE 3 KNOWLEDGE CHECK EXAM
If a hospital treats a high percentage of patients with lower incomes, it
receives a percentage add-on payment applied to its adjusted base rate
DRG payment under the Inpatient Prospective Payment System (IPPS).
What is this add-on called? ANS >> disproportionate share hospital
adjustment
Why does the Home Health Resource Group require the identification
of a comorbidity adjustment category? ANS >> to determine the
necessity of continued care
How are patient diagnoses identified in the Major Diagnostic Categories
(MDCs) within the DRG system? ANS >> by ICD-10-CM diagnosis codes
In the Inpatient Prospective Payment (IPPS) formula used to calculate
an acute inpatient hospital's payment for treating Medicare patients
assigned to a DRG, what factor represents the resource intensity of that
DRG classification based on the average resources used to treat all
Medicare patients in the DRG? ANS >> relative weight
Course lessons introduced a system of service payments with CMS as a
way to control rising costs for health care services. How many principles
were introduced? ANS >> 4
Identify the legislation that provided a prospective payment system
(PPS) for long-term care inpatient hospitals (Latch’s), those that treat
medically complex patients with an average length of stay greater than