CCDS EXAM (Latest 2023 – 2024) With
Complete Verified Solution
Blended rate - The base rate plus any add-on reimbursement factors (eg for indirect costs of
medical education, capital acquisitions, and disproportionate share of Medicare patients)
Case-Mix index (CMI) - The sum of all DRG relative weights divided by the number of Medicare
cases. A low CMI may denote DRG assignments that do not adequately reflect the resources used to
treat Medicare patients.
CMS - The Centers for Medicare and Medicaid, formerly HCFA, the federal agency within the U.S.
Department of Health and Human Services (HHS) that administers the Medicare program and
works in partnership with the state governments to administer Medicaid and the State Children's
Health Insurance Program (SCHIP)
CC Complication and Comorbidity - A condition that, when present, leads to substantially increased
hospital resource use, such as intensive monitoring, expensive and technically complex services,
and extensive care requiring a greater number of caregivers. Significant acute diseases, acute
exacerbations of significant chronic diseases, advanced or end-stage chronic diseases, and chronic
diseases associated with extensive debility are representative of CC conditions. Some examples are
UTI, acute respiratory insufficiency, and hyponatremia.
ICD-9-CM - The International Classification of Diseases, 9th Revision, Clinical Modification. This is
the official system of assigning codes to diagnoses and procedures associated with hospital
utilization in the United States.
IPPS Inpatient prospective payment system - A government system for reimbursement of hospital
services based on prospectively set rates.
MCC Major complication and comorbidity - Diagnosis code that reflects the highest level of severity
of illness. Some examples are sepsis, acute respiratory failure, acute renal failure, and acute
systolic/diastolic heart failure.
Complete Verified Solution
Blended rate - The base rate plus any add-on reimbursement factors (eg for indirect costs of
medical education, capital acquisitions, and disproportionate share of Medicare patients)
Case-Mix index (CMI) - The sum of all DRG relative weights divided by the number of Medicare
cases. A low CMI may denote DRG assignments that do not adequately reflect the resources used to
treat Medicare patients.
CMS - The Centers for Medicare and Medicaid, formerly HCFA, the federal agency within the U.S.
Department of Health and Human Services (HHS) that administers the Medicare program and
works in partnership with the state governments to administer Medicaid and the State Children's
Health Insurance Program (SCHIP)
CC Complication and Comorbidity - A condition that, when present, leads to substantially increased
hospital resource use, such as intensive monitoring, expensive and technically complex services,
and extensive care requiring a greater number of caregivers. Significant acute diseases, acute
exacerbations of significant chronic diseases, advanced or end-stage chronic diseases, and chronic
diseases associated with extensive debility are representative of CC conditions. Some examples are
UTI, acute respiratory insufficiency, and hyponatremia.
ICD-9-CM - The International Classification of Diseases, 9th Revision, Clinical Modification. This is
the official system of assigning codes to diagnoses and procedures associated with hospital
utilization in the United States.
IPPS Inpatient prospective payment system - A government system for reimbursement of hospital
services based on prospectively set rates.
MCC Major complication and comorbidity - Diagnosis code that reflects the highest level of severity
of illness. Some examples are sepsis, acute respiratory failure, acute renal failure, and acute
systolic/diastolic heart failure.
