AHIMA CCS Exam Prep Questions and Answers Already Passed

AHIMA CCS Exam Prep Questions and Answers Already Passed CPT defines a separate procedure as Procedure considered an integral part of a more major service No combination code available Use separate codes for hypertension and acute renal failure Documentation from the nursing staff or other allied health professionals' notes can be used to provide specificity for code assignment for which of the following diagnoses? Body Mass Index (BMI) POA Indicator - Y Y-Yes, present at the time of inpatient admission POA Indicator - N N-No, not present at the time of inpatient admission POA Indicator - U U-Unknown, documentation is insufficient to determine if condition is present on admission and you cannot speak to the physician to figure it out POA Indicator - W W-Clinically undetermined, provider is unable to clinically determine whether condition was present on admission or not POA Indicator - E E-Exempt, unreported/not used, some facilities will leave these blank, others will use the letter "E" Present on Admission Indicator (POA) A Present On Admission (POA) indicator is required on all diagnosis codes for the inpatient setting except for admission. The indicator should be reported for principal diagnosis codes, secondary diagnosis codes, Z-codes, and External cause injury codes. The use of the outpatient code editor (OCE) is designed to: Identify incomplete and incorrect claims Medicare's identification of medically necessary services is outlined in: Local Coverage Determinations (LCDs) Medically unlikely edits are used to identify: Maximum units of service for a HCPCS code National Correct Coding Initiative (NCCI) Edits are released how often? Quarterly In 2000, CMS issued the final rule on the outpatient prospective payment system (OPPS). The final rule: Divided outpatient services into fixed payment groups Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs) are similar in that they are both: Prospective payment systems What are APCs? APCs or "Ambulatory Payment Classifications" are the government's method of paying facilities for outpatient services for the Medicare program. How do APCs work? The payments are calculated by multiplying the APCs relative weight by the OPPS conversion factor and then there is a minor adjustment for geographic location. APC Status Indicator - C Inpatient Procedures, not paid under OPPS APC Status Indicator - N Items and Services Packaged into APC Rates APC Status Indicator - S Significant Procedure, Not Discounted When Multiple APC Status Indicator - T Significant Procedure, Multiple Reduction Applies APC Status Indicator - V Clinic or Emergency Department