Uniform Hospital Discharge Data Set
(UHDDS) Chap.4 Exam Questions With
Correct Answers.
Uniform Hospital Discharge Data Set (UHDDS) - answer✔✔Used for reporting inpatient data in
*acute care,
short-term care, and
long-term care hospitals.*
Minimum set of items based on standard definitions to provide consistent data for multiple users.
Required for reporting Medicare and Medicaid patients.
Many other health care payers use UHDDS for the uniform billing system.
UHDDS requiered data item - answer✔✔The UHDDS requires the following items:
*Principal diagnosis*
*Other diagnoses that have significance for the specific hospital episode*
*Age, sex, and race of the patient,
Expected payer, and
Hospital's identification*
UHDDS application - answer✔✔Definitions and guidelines for selection of principal diagnosis
and other (secondary) diagnoses apply to:
*Acute care short-term hospitals*
*Long-term care hospitals*,
*Psychiatric hospitals*,
*Home health agencies*
*Rehabilitation facilities*,
*Nursing homes, and other settings*.
Principal Diagnosis- Definition and Importance - answer✔✔*Definition: The condition
established after study to be chiefly responsible for admission of the patient to the hospital*.
*Importance of correct selection:*
Significant in cost comparisons, in care analysis, and in utilization review.
Crucial for reimbursement because many third-party payers (including Medicare) *base
reimbursement primarily on principal diagnosis*.
Principal Diagnosis and " After study" - answer✔✔*The principal diagnosis is NOT the
admitting diagnosis* BUT the diagnosis found after workup or surgery that proves to be the
reason for admission.
*The principal diagnosis is ordinarily listed first in the physician's diagnostic statement*,
*but this is not always the case.*
1+ Always review the entire medical record
2+ determine the condition that should be designated as the principal diagnosis.
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