1
WGU C807 Task 1 |Latest Update with Complete
Solution
Kenzi Brooks
Healthcare Compliance C807
Task 1
January 11,2025
A1.
There..are..many..jobs..within..the..health..information..management..field,. . inclu
ding. . medical. . coding.. . Interpreting. . medical. . record. . documentation. . and..assignin
g. . codes. . for. . the. . document. . to. . be. . billed. . is. . one. . of. . the. . coders'. . jobs.. . Both..inpa
tient. . and. . outpatient. . coders. . need. . to. . be. . accurate. . when. . applying. . codes.. . If. . ther
e..are. . errors. . in. . coding,. . it. . can. . impact. . an. . organization's. . financial. . status.. . Code
rs. . must..be. . up. . to. . date. . on. . both. . ICD. . (international. . classification. . of. . disease),. .
and. . CPT..(current..procedural..terminology)..for..medical..diagnosis..procedures..and..s
ervices. . provided.. . Some. . coders. . may. . even. . need. . knowledge. . of. . HCPCS. . (healthc
are. . common..procedure. . coding. . system),. . which. . is. . a. . system. . that. . is. . used. . with
. . Medicare. . and..Medicaid..and..some..third-
party..payers...Coders..must..have..knowledge..of..medical. . terminology,. . anatomy,. . an
d. . procedures. . so. . that. . the. . charts. . are. . coded. . appropriately..on..the..inpatient..and..
outpatient..side.
, 2
Inpatient..coders..are..responsible..for..patients..with..more..than..24..hours..of..sta
y..in..the..hospital...They..will..assign..ICD-
..10..diagnosis..codes,..ICD..10..PCs..for..procedures,..and..HCPCS..level..two..for..supplie
s..and..medications..that..do..not..fall..under..the..CPT...Inpatient..coders..need..to..under
stand..DRG(diagnosis-
r..elated..group)..coding...DRG..uses..a..relative..weight,..which..means..the..average..am
ount..of..resources..required..to..care..during..the..hospital..stay.
Outpatient..coders..use..ICD..10..codes,..CPT..codes,..and..HCPCS..for..services..in
..the..outpatient..space...The..outpatient..space..maybe..office..settings,..emergency..roo
m..visits,..observation..stay,..and..same..day..surgeries.
A2.
The..clinical..documentation..improvement..(CDI)..program..is..important..to..help
..with..correct..and..better..documentation...The..CDI..program..can..be..in..the..inpatient
..and..outpatient..space...The..CDI..inpatient..specialist..may..conduct..concurrent..and..r
etrospective..reviews..of..the..health..care..record..for..correct..and..complete..documen
tation...CDI's..in..the..inpatient..space..help..with..the..DRG's,..documenting..mortality,. . t
he..medical..severity..of..the..illness..and..help..report..data..to..other..programs...The..CD
I..outpatient..specialist..may..conduct..prospective,..concurrent,..and..retrospective..re
views..of..the..record..for..complete..and..correct..documentation...The..CDI..team..allow
s..for..clarifications..to..be..made..when..needed.
Having. . a. . CDI. . program. . decreases. . the. . number. . of. . denials. . from. . claims. . tha
t. . are..submitted.. . CDIs. . not. . only. . need. . to. . have. . a. . strong. . coding. . background,. . bu
t. . it. . also..helps. . them. . to. . have. . a. . clinical. . background.. . They. . helped. . to. . paint. . the. .
picture. . of. . this..patient. . along. . with. . assuring. . the. . documentation. . matches.. . CDI. . sp
ecialists. . need. . to. . be..able. . to. . answer. . providers'. . questions. . (queries). . in. . a. . profes
sional. . manner.
WGU C807 Task 1 |Latest Update with Complete
Solution
Kenzi Brooks
Healthcare Compliance C807
Task 1
January 11,2025
A1.
There..are..many..jobs..within..the..health..information..management..field,. . inclu
ding. . medical. . coding.. . Interpreting. . medical. . record. . documentation. . and..assignin
g. . codes. . for. . the. . document. . to. . be. . billed. . is. . one. . of. . the. . coders'. . jobs.. . Both..inpa
tient. . and. . outpatient. . coders. . need. . to. . be. . accurate. . when. . applying. . codes.. . If. . ther
e..are. . errors. . in. . coding,. . it. . can. . impact. . an. . organization's. . financial. . status.. . Code
rs. . must..be. . up. . to. . date. . on. . both. . ICD. . (international. . classification. . of. . disease),. .
and. . CPT..(current..procedural..terminology)..for..medical..diagnosis..procedures..and..s
ervices. . provided.. . Some. . coders. . may. . even. . need. . knowledge. . of. . HCPCS. . (healthc
are. . common..procedure. . coding. . system),. . which. . is. . a. . system. . that. . is. . used. . with
. . Medicare. . and..Medicaid..and..some..third-
party..payers...Coders..must..have..knowledge..of..medical. . terminology,. . anatomy,. . an
d. . procedures. . so. . that. . the. . charts. . are. . coded. . appropriately..on..the..inpatient..and..
outpatient..side.
, 2
Inpatient..coders..are..responsible..for..patients..with..more..than..24..hours..of..sta
y..in..the..hospital...They..will..assign..ICD-
..10..diagnosis..codes,..ICD..10..PCs..for..procedures,..and..HCPCS..level..two..for..supplie
s..and..medications..that..do..not..fall..under..the..CPT...Inpatient..coders..need..to..under
stand..DRG(diagnosis-
r..elated..group)..coding...DRG..uses..a..relative..weight,..which..means..the..average..am
ount..of..resources..required..to..care..during..the..hospital..stay.
Outpatient..coders..use..ICD..10..codes,..CPT..codes,..and..HCPCS..for..services..in
..the..outpatient..space...The..outpatient..space..maybe..office..settings,..emergency..roo
m..visits,..observation..stay,..and..same..day..surgeries.
A2.
The..clinical..documentation..improvement..(CDI)..program..is..important..to..help
..with..correct..and..better..documentation...The..CDI..program..can..be..in..the..inpatient
..and..outpatient..space...The..CDI..inpatient..specialist..may..conduct..concurrent..and..r
etrospective..reviews..of..the..health..care..record..for..correct..and..complete..documen
tation...CDI's..in..the..inpatient..space..help..with..the..DRG's,..documenting..mortality,. . t
he..medical..severity..of..the..illness..and..help..report..data..to..other..programs...The..CD
I..outpatient..specialist..may..conduct..prospective,..concurrent,..and..retrospective..re
views..of..the..record..for..complete..and..correct..documentation...The..CDI..team..allow
s..for..clarifications..to..be..made..when..needed.
Having. . a. . CDI. . program. . decreases. . the. . number. . of. . denials. . from. . claims. . tha
t. . are..submitted.. . CDIs. . not. . only. . need. . to. . have. . a. . strong. . coding. . background,. . bu
t. . it. . also..helps. . them. . to. . have. . a. . clinical. . background.. . They. . helped. . to. . paint. . the. .
picture. . of. . this..patient. . along. . with. . assuring. . the. . documentation. . matches.. . CDI. . sp
ecialists. . need. . to. . be..able. . to. . answer. . providers'. . questions. . (queries). . in. . a. . profes
sional. . manner.
