CCS Exam Prep, Questions and answers, 100% Accurate, rated A+

CCS Exam Prep, Questions and answers, 100% Accurate, rated A+ The use of the outpatient code editor (OCE) is designed to: - ✔✔-Identify incomplete or incorrect claims Medicare's identification of medically necessary ...

CCS Exam Prep, Questions and answers, 100% Accurate, rated A+ The use of the outpatient code editor (OCE) is designed to: - ✔✔-Identify incomplete or incorrect claims Medicare's identification of medically necessary services is outlined in: - ✔✔-Local coverage determinations National Correct Coding Initiative (NCCI) are released how often? - ✔✔-Quarterly In 2000, the CMS issued the final rule on the outpatient prospective payment system. The final rule: - ✔✔-Divided outpatient services into fixed payment groups DRG's and ambulatory patient classifications are similar in that they are both: - ✔✔-Prospective payment systems Medicare exerts control of provider reimbursement through adjustment of this component of the resource-based relative value scale - ✔✔-Conversion factor The process of collecting data elements from a source document is known as: - ✔✔-Abstracting What piece of claims data from Hospital A alerts a payer that the patient was transferred to Hospital B? - ✔✔-Discharge disposition Which of the following is considered a complication or comorbidity? - ✔✔-Hypernatremia Multiple choice queries must supply how many choices in order to be compliant? - ✔✔-No specific number Compliant queries include which of the following? - ✔✔-Relevant clinical indicators Authentication of health record entries means to: - ✔✔-Prove authorship of documents The requirements for documentation and record completion (such as H&P's, discharge summaries, and consultations) as well as penalties for non-adherence must be specified in: - ✔✔-Medical staff bylaws Generally, data quality is defined as: - ✔✔-Ensuring the accuracy and completeness of an organization's data The Joint Commission considers management that supports decision making to be important for safety and quality. What kind of management supports decision making? - ✔✔- Which type of conditions are always considered present on admission? - ✔✔-Congenital A patient is admitted for seizures. What is the appropriate POA for the external cause code of W06.XXA assigned because the patient fell out of bed during a seizure in the ER? - ✔✔-Y The outpatient code editor (OCE) has all of the following types of edits except: - ✔✔-Valid diagnosis code edits Determining medical necessity for outpatient services include all of the following except: - ✔✔- Requiring new HCPCS codes be developed to replace codes in the CPT code book The National Correct Coding Initiative (NCCI) Edits apply to services billed by: - ✔✔-The same provider, for same beneficiary, on same date of service If the principle diagnosis is an initial anterior wall myocardial infarction, which procedure will result in the highest MS-DRG assignment? - ✔✔-Transbronchial lung biopsy Medicare payment to physicians for services rendered is made under the: - ✔✔-Resource-based Relative Value Scale Inpatient procedures are coded with - ✔✔-ICD-10-PCS Under the inpatient prospective payment system (IPPS), what can be used to measure the cost of care for inpatients? - ✔✔-Case-mix index The abstracting of this data element has an impact on the DRG reimbursement: - ✔✔-Discharge disposition Which of the following is a data element that coders typically are tasked with abstracting? - ✔✔-Date of surgery When a patient goes home with an order for home health to start one week after inpatient admission, this is categorized as a(n): - ✔✔-discharge A patient is admitted with an acute inferior myocardial infarction and discharged alive. Which condition would increase the MS-DRG weight? - ✔✔-Respiratory failure A female patient is diagnosed with congestive heart failure. Which of the following will increase the MSDRG weight if present on admission? - ✔✔-State III pressure ulcer of coccyx Major complications and comorbidities (MCCs) are determined to require the greatest degree of resources with a payment group and also reflect the greatest: - ✔✔-SOI (Severity of Illness) SOI - ✔✔-Severity of Illness ROM - ✔✔-risk of mortality ROI - ✔✔-release of information SNF - ✔✔-Skilled nursing facility Which of the following diagnoses qualifies as MCC? - ✔✔-Type 2 myoca