CIC PREDICTOR QUESTIONS WITH ANSWERS VERIFIED

CIC PREDICTOR QUESTIONS WITH ANSWERS VERIFIED Hospital inpatient services include all - CORRECT ANSWER-services provided to patents requiring an inpatient admission. An inpatient is formally admitted to a hospital with a/an - CORRECT ANSWERphysician's order. The decision for the inpatient hospital admission is based on the physician's judgment and the need for - CORRECT ANSWER-medically necessary hospital care. Patients can be admitted through the - CORRECT ANSWER-emergency department, observation, following surgical procedures, from clinics, or at physician's request. The patients condition must demonstrate _____ ____ to require an inpatient stay. - CORRECT ANSWER-Medically Necessary For _____ patients, the inpatient hospital admission is generally considered appropriate then the patient is expected to to remain in the hospital for medically necessary care for two or more midnights. - CORRECT ANSWER-Medicare The physician must order the admission and the faculty must formally admit the patient. - CORRECT ANSWER-Medicare Patients The CMS established this requirement know as the _____ _____ _____, as a benchmark to determine patient status for an inpatient or outpatient care. - CORRECT ANSWER-Two Midnight Rule CMS - CORRECT ANSWER-Centers for Medicare and Medicaid Services CMS specifies that when the physican expects the patient to require care that crosses two midnights and orders _____ based on the expectation, inpatient status is generally appropriate. - CORRECT ANSWER-Admission Conversely, hospitals stays in which the physician expects the patient to require care for fewer than _____ _____ are considered outpatient care, as inpatient status would generally be inappropriate. - CORRECT ANSWER-Two midnights Exceptions to the two midnight rule are admissions for the performance of procedures found on the _____ _____ _____ list, regardless of length of stay. - CORRECT ANSWER-Medicare Inpatient Only Situations of _____ _____ _____ _____ are also exceptions to the two midnight rule/ - CORRECT ANSWER-Transfers and Patient Expiration The two-midnight rule applies to all inpatient acute care hospitals, including _____, and _____; however it does not apply to _____. Specific regulatory guidelines apply for admission to these units and facilities. - CORRECT ANSWER-LTCH, CAH, IRF LTCH - CORRECT ANSWER-Long Term Care Hospitals CAH - CORRECT ANSWER-Critical Access Hospitals IRF - CORRECT ANSWER-Inpatient Rehab Facilities. CMS defines inpatient hospital services or inpatient CAH services as the following, when provided to an inpatient of participating hospital or critical access hospital: - CORRECT ANSWER-1. Bed and Board 2. Nursing Services and Other Related Services 3. Use of Hospital or CAH Facilities 4. Medical Social Services 5. Drugs, Biologicals, Supplies, Appliances and Equipment 6. Certain other Diagnostic or Therapeutic Services 7. Medical or Surgical Services Provided by Certain Interns or Residents in Training 8.Transportation Services, Including Transport by an Ambluance Inpatient services do not include: - CORRECT ANSWER-1. Posthospital SNF Care Furnished by a Hospital or a CAH That Has a Swing-Bed Approval. 2. Nursing Facility Services That May be Furnished as a Medicaid Service Under Title XIX of the Act in a Swing-Bed Hospital That Has an Approval to Furnish Nursing Facility Services 3. Physician Services for Payment on a Fee Schedule Basis 4. Physician Assistant Services Defined in 1861(Ii) of the Act 5. Nurse Practitioner and Clinical Nurse Specialist Services. 6. Certified Nurse Mid-Wife Services 7. Qualified Psychologist Services 8. Services of an Anesthetist SNF - CORRECT ANSWER-Skilled Nursing Facilities ASC - CORRECT ANSWER-Ambulatory Surgical Center CORF - CORRECT ANSWER-Comprehensive Outpatient Rehabilitation Facility ACF - CORRECT ANSWER-Acute Care Facility Acute Care Facility - CORRECT ANSWER-A Healthcare Facility That Provides Continuous Professional Medical Care to Patients in an Acute Phase of Illness/ Ambulatory Surgery - CORRECT ANSWER-Surgical Procedures Preformed on a Patient Who is Admitted, Treated, and Released on the Same Day ASC Surgical Procedures - CORRECT ANSWER-Surgical Procedures Performed on an Outpatient Basis Clinic - CORRECT ANSWER-An Outpatient Facility That Provides Scheduled Diagnostic, Curative, Rehabilitative, and Education Services for Walk-In (Ambulatory Patients) Consultation - CORRECT ANSWER-Advice or Opinion Rendered at the Request of Another Qualified Provider Cost Report (Medicare) - CORRECT ANSWER-An Annual Report Required of Facility Contractors Participating in the Medicare Program. The Report Details the Cost and Charges the Provider Incurred in Rendering Services to all Patients, and the Medicare Payments Received During a Specific Reporting Period. Cost and Reporting Procedures are Defined by the Medicare Program. Critical Access Hospitals - CORRECT ANSWER-A Hospital Certified Under a Set of Medicare CoP, Which are Structured Differently Than the Acute Care Hospital CoP. Requirements for CAH Certification Include Having no More Than 25 Inpatient Beds; Maintaining an Annual Average Lenght of Stay of no More Than 96 Hours for Acute Inpatient Care; Offering 24-Hour, 7-Day-a-Week Emergency Care; and Being Located in A Rural Area, at Least 35 Miles Drive Away From Any Other Hospital or CAH. CoP - CORRECT ANSWER-Medicare Conditions of Participation DRG - CORRECT ANSWER-Diagnosis Related Groups Diagnosis Related Groups - CORRECT ANSWER-A Patient Classification Scheme That Relates the Type of Patients a Hospital Treats (i.e., Its Case Mix) to the Costs Incurred by the Hospital. Diagnosis Laboratory Services - CORRECT ANSWER-Laboratory Services Required in the Diagnosis of a Disease or Injury, Regardless of Where the Services are Rendered. For Medicare Purposes, These Services are Paid Under a Separate Fee Schedule. These Services Include Clinical Lab Tests Performed on Automated Multichannel Analyzers Diagnosis Services - CORRECT ANSWER-An Examination or Procedure Performed on a Patient to Obtain Information to Access the Medical Condition of the Patient or to Identify a Disease and/or to Determine the Nature and Severity of an illness or Injury.