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Domain 4 CDIP notes Part 1 of 6, Questions & Answers, 100% Accurate. Why hire Medicare Contractor Reviewers? - -For Protection of Medicare Trust Fund. Who is 1st of 6 Medicare Contract Reviewers? - -(MACs) Medicare Administrative Contractors Whos is 2nd of 6 Medicare Contract Reviewers? - -(RACs) Recovery Auditor Contractors Who's 3rd of 6 Medicare Contractor Reviewers? - -(CERTs) Comprehensive Error Rate Testing Contractors Who's 4th of 6 Medicare Contract Reviewers? - -(SMR...

CDIP Prep Questions & Answers, 100% Accurate. Rated A+ The AHA, AHIMA, CMS, and the NCHS are all: - -Cooperating parties A patient was admitted with H.I.V. and pneumocystis carini. The patient should have a principal diagnosis in ICD-10 of: - -AIDS During an outpatient procedure for removal of a bladder cyst, the urologist accidently tore the urethral sphincter requiring an observation stay. What is the principal diagnosis? - -The reason for the outpatient surgery In 1990, 3M creat...

CDIP Domain 2: Leadership Questions and answers, 100% accurate. AHIMA - -American Health Information Management Association ACDIS - -Association of Clinical Documentation Improvement Specialists IDT - -Interdisciplinary Team LOS - -Length of Stay The RHIT, RHIA or CCS should have how many years of inpatient coding experience before becoming a CDI specialist? - -at least 3-5 years Hospitalists - -Physicians whose primary professional focus is the general medical care of hospit...

CDIP Practice Exam 2 Top Questions and answers, 100% Accurate. Graded A+ A physician admits a patient with shortness of breath and chest pain, then treats the patient with Lasix, oxygen, and Theophylline. The physician's final documented diagnosis for the patient is acute exacerbation of COPD. What is missing from this diagnosis that would make it reliable information in the treatment of this patient? a.No additional information is needed. b.The type of COPD c.The reason the patient was...

CDI Question and Answer Key, Questions & Answers, 100% Accurate. What is a reason a physician documentation can be difficult to review? - -Illegible handwriting The best scientific data available for clinical documentation is also known as - -Evidence-based medicine The two-part theory for high-quality clinical documentation is a cause-and-effect theory that is derived from which two sources? - -Legal/Regulatory Sources and Peer-Reviewed Research When discussing completeness in a h...

CDIP Domain 1: Clinical Coding Practice, Questions & Answers, 100% Accurate. Coding Clinic - -Valuable reference tool for coders that is published by AHA each quarter CPT - -Current Procedural Terminology MS-DRGs - -Medicare Severity-Diagnosis Related Groups CPT Assistant - -Monthly publication by the AMA that provides coding advice for CPT coding scenarios Encoder Nosology - -Provides coding professionals from the encoder company that are available to help answer tough coding q...

CDIP Practice Exam 1 Questions & Answers, 100% Accurate, Graded A+ Assign code(s) for the following diagnosis: Congestive heart failure due to hypertension. I10 Essential (primary) hypertension I11.9 Hypertensive heart disease without heart failure I11.0 Hypertensive heart disease with heart failure I50.9 Heart failure, unspecified I50.1 Left ventricular failure I50.20 Unspecified systolic (congestive) heart failure I50.21 Acute systolic (congestive) heart failure I50.22 Chronic sys...

CDIP Domain 1: Clinical Coding Practice, Questions & Answers, 100% Accurate, Graded A Coding Clinic - -Valuable reference tool for coders that is published by AHA each quarter CPT - -Current Procedural Terminology MS-DRGs - -Medicare Severity-Diagnosis Related Groups CPT Assistant - -Monthly publication by the AMA that provides coding advice for CPT coding scenarios Encoder Nosology - -Provides coding professionals from the encoder company that are available to help answer tough...

CDIP Exam Questions and answers, 100% Accurate, Graded A+ CDI program data includes: - -1. All cases that were reviewed 2. Number of cases with queries 3. Nature of the query 4. Physician response to the query Queries should only be asked: - -1. If there is clinical evidence that the documentation is imcomplete or does not meet one of the seven criteria for high-quality clinical documentation. 2. By an individual with solid clinical knowledge. 3. In an open-ended manner (no yes or n...

CDIP EXAM PREP, Exam Questions sections coverage, Rated A+ OIG - -Office of Inspector General- established by the Dept. of Labor by the Inspector General Act of 1978 to identify fraud and abuse of Medicare part A and part B programs MAC - -Medicare Administrative Contractor - used by the OIG to process claims for services rendered Criteria for high quality documemtation - -1. Legible 2. Reliable 3. Precise 4. Complete 5. Consistent 6. Clear 7. Timely EBM - -Evidence Based ...

Domain 4 CDIP notes Part 1 of 6, Top Exam Questions and answers, 100% Accuratee. Why hire Medicare Contractor Reviewers? - -For Protection of Medicare Trust Fund. Who is 1st of 6 Medicare Contract Reviewers? - -(MACs) Medicare Administrative Contractors Whos is 2nd of 6 Medicare Contract Reviewers? - -(RACs) Recovery Auditor Contractors Who's 3rd of 6 Medicare Contractor Reviewers? - -(CERTs) Comprehensive Error Rate Testing Contractors Who's 4th of 6 Medicare Contract Revie...

CPMA Top Exam Questions and answers. Approved Rated A+ Which option is NOT part of the seven elements that should be included in a compliance plan based on the OIG's recommendations? a. Responding promptly to detected offenses and developing corrective action. b. Conducting effective training and education. c. Identifying employees on the exclusions list. d. Developing effective lines of communication. - -c. Identifying employees on the exclusions list. The OIG's Compliance Program ...

CPMA Chapter 1, Questions and answers, 100% Accurate, rated A Stark Law - -Physician Self Referral Law Prohibits a physician from making a referral to an entity with which they or their immediate family has a financial relationship if the referral is for the furnishing of designated health services RAT-STATS - -A statistical software that is a valuable analytical tool used by auditors Components of RAT-STATS that should be used to perform CIA Claims Review - -"Random Numbers" to dr...

CPMA EXAM chapter 5. Questions and answers, 100% Accurate. Approved. Which statement is true regarding an audit performed on charts for Medicare beneficiaries? - -National CMS policies and local MAC policies should be utilized when performing Medicare audits. In addition to CMS it is necessary to know your Medicare Administrative Contractor that supports the location where services are rendered for example 4x4 rule. How often should an internal audit be conducted minimally? - -Annually (...

CPMA Exam Questions and answers, 100% Accurate, graded A+ Fraud or Abuse: Billing for a service at a higher level than provided - -Fraud What is a Qua Tam relator? - -A person who brings a civil action for a violation for him/herself & for US Govt What is the difference between Stark Law & Antikickback law? - -No INTENT must be provien for Stark, Antikickpack requires proof of intent When banned for Fed/State healthcare program, what is the term of exclusion (in Years)? - -5 years ...

CPMA Practice Exam A, Questions and answers, 100% Accurate, rated A+ You are performing an audit of evaluation and management services for a family practice office. In the encounter, you read the physician order and reviewed a differential WBC. Which of the following best describes what you would expect to see in the medical record? - -Patient identification, assignment of benefits, patient's medical history, immunizations, physical examination, lab report, clinical impression, and physici...

CPMA STUDY QUESTIONS & Answers, 100% Accurate. Graded A+ WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE? - -1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation and health plan request and denial. Exclusion Statute - -1.Physician is banned from participating in any federal or state healthcare program by OIG 2. The...

AAPC CPMA Practice Exam Study Questions and answers, 100% Accurate, rated A+ What elements must be in a medical record - -Patient ID, Assignment of Benefits, medical history, immunizations, physical exam, lab report, clinical impression, physician orders What is the minimum signature assignment of the author of entry in the medical record? - -First initial, Last Name and credentials Based on the JC accreditation guidelines for personal data, what 2 elements must be evident in the medi...

AAPC CASES CPMA Review Questions and answers, 100% Accurate, rated A+ You are performing an audit of evaluation and management services for a family practice office. In the encounter, you read the physician ordered and reviewed a differential WBC. Which of the following best describes what you would expect to see in the medical record? - -Patient identification, assignment of benefits, patient's medical history, immunizations, physical examination, lab report, clinical impression, and phys...

CPMA Top Exam Questions and answers With rationale, 100% Accurate. Verified. B. If documentation supports the service, have the staff contact the carrier to reprocess the claims. Code 33010 was valid for the date of service billed. Rationale: The effective dates of codes are date of service driven. New CPT® codes become effective January 1st of every year. When auditing, verify codes based on the codes that were valid during the date of service. - -In February 2020, an auditor is asked to...