WGU C807 Task 1 Healthcare Compliance |Latest Update with Complete Solution

WGU C807 Task 1 Healthcare Compliance
|Latest Update with Complete Solution


A1:..INPATIENT..AND..OUTPATIENT..CODERS


Inpatient..coders..review..the..medical..record..for..details..about..diagno

sis,..treatments,..and..hospital..stays...Inpatient..coders..translate..the..inform

ation..reviewed..to..determine..and..assign..the..most..appropriate..codes..for..t

he..diagnosis...These..coders..perform..complex..diagnostical..and..procedure..

coding..for..accurate..diagnosis-

related..groups,..severity..of..illness,..and..risk..of..mortality..assignment..(Oac

hs,..P.,..Watters,..A.,..2020)...Inpatient..coders..communicate..with..doctors..a

nd..other..healthcare..professionals..to..clarify..the..information..and..obtain..

more..details..when..needed...Inpatient..coders..can..assign..codes..for..unconfi

rmed..diagnoses.


Outpatient..coders..review..the..medical..records..of..patients..who..recei

ve..treatment..or..have..procedures..at..a..hospital..or..clinic..without..needing..

admission...Outpatient..coders..use..(CPT)..current..procedural..terminology..

or..(HCPCS)..healthcare..common..procedure..coding..system..to..translate..inf

ormation..reviewed..into..codes...All..documented..conditions..present..at..the..

time..of..treatment..will..be..coded..for..each..instance..of..care..the..patient..rece

ives.. . Outpatient..coders..can..only..code..a..diagnosis..if..the..diagnosis..has..be

, en..confirmed...Outpatient..coders..also..communicate..with..physicians..and..

other..professionals..when..clarity..is..needed..for..presented..documentation..

or..to..request..additional..information..(Oachs,..P.,..Watters,..A.,..2020)...Inpat

ient..and..outpatient..coders..ensure..that..coding..is..completed..in..complianc

e..with..federal..regulations..and..insurance..requirements.




A2:..CDI.. PROGRAM


Clinical..document..improvement..is..a..process..to..produce..better..doc

umentation..that..easily..shows..the..care..the..patient..received..and..the..reaso

ns..for..the..treatment..provided...CDI..programs..initiate..concurrent..reviews..

of..medical..records..while..patient..care..is..ongoing..and..retrospective..review

s..after..the..patient..is..discharged...These..reviews..aim..to..identify..conflictin

g..information..and..incomplete..or..non-

specific..provider..documentation...CDI..programs..support..quality..improvem

ent..utilization..and..programs..for..risk..management.


A3:.. APPLICANT.. EVALUATION


Organizations..seeking..to..fill..coding..department..positions..should..de

velop..a..standard..evaluation..procedure..to..ensure..they..find..the..right. . pers

on..to..join..the..team...Prospective..coders..need..to..possess..familiarity..with..

Medicare..and..private-

payer..regulations...Determine..if..the..prospect..analyzed..the..data..and..chose.

.the..codes..or..if..the..EMR..system..automatically ..coded..the..data...Verify..the..


average..number..of..charts..they..can..code..in..a..given..day..and..their..average..