CEHRS Exam with Complete Solutions
Health Care Common Procedure Coding System (HCPCS) - Answer-A numeric and alphabetic coding system used for billing and pricing of procedures, medical supplies, medications, and durable medical equipment
International Classification of Diseases, Ninth Revisi...
CEHRS Exam with Complete
Solutions
Health Care Common Procedure Coding System (HCPCS) - Answer-A numeric and
alphabetic coding system used for billing and pricing of procedures, medical supplies,
medications, and durable medical equipment
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-
CM) codes - Answer-Alphanumeric codes used to classify injuries, diseases, symptoms,
and cause of death
Insurance verification - Answer-Process used to make sure the service received by the
patient is approved and paid for by the insurance company
National provider identifier (NPI) number - Answer-A unique 10-digit number assigned
to providers in the U.S. to identify themselves in all HIPAA transactions
Practice management systems - Answer-A software designed to assist in the office
workflow by streamlining scheduling, insurance information, patient demographics, and
billing
Third-party vendor - Answer-A separate business that handles a specific task for a
facility; common third-party vendors include billing companies, transcription companies,
and coding firms
Ad hoc reports - Answer-Reports created or programmed in response to an inquiry or
issue that comes up; they are not normally scheduled reports
Compliance - Answer-Compliance as it relates to paper or electronic medical records
refers to the completion of the record and the adherence to medical records and
documentation requirements set forth by state and federal law, as well as accreditation
and regulatory agencies
Database queries - Answer-Reports run on records stored in a database to find specific
information; an ad hoc report is set up by a query
Diagnosis-related groups (DRGs) - Answer-Assigned to inpatients based on the
principle diagnosis; determines the hospitals reimbursement; based on the perspective
payment system
Garbage-in, garbage-out (GIGO) - Answer-Refers to the fact that poor documentation or
data entry results in poor output from a computer or information system
, Incomplete charts - Answer-Charts that are missing signatures, reports, or other
required elements as outlined in either CMS Conditions for Participation or Medical
Record Services or the Joint Commission accreditation guidelines for information
management
Payers - Answer-Another word for insurance companies or the responsible party who
will pay for the medical services patients receive; when patients don't have insurance,
the payer listed on the bill is self-pay
Point-of-Care (POC) charting - Answer-The ability of providers to document the care
and treatment they render in real time, when they are with the patient; it is made much
easier with the use of clinical templates, digital dictation, point-and-click menus, and
other technology solutions
Record destruction policy - Answer-Facilities that maintain medical records of any form
must have a record destruction policy in place; an attorney should guide the
development of any policy records and consider state and regular laws, along with any
regulatory and accreditation requirements
Record retention - Answer-How long to retain medical records is a policy decision based
on state and federal laws and regulatory and accreditation agency guidelines; an
attorney should guide the development of any policy and consider facility needs that
include patient characteristics, demographics, type of facility, and the availability of
archived records and how that meets provider and patient needs
Redundant data storage - Answer-Storing data from your facility is more than one
location so If one area is hit with a disaster event, the data is restored from a copy
located elsewhere
Affordable Care Act - Answer-Mandates comprehensive health insurance reform; some
of the provisions of this law include prohibiting the denial of coverage based on pre-
existing conditions, preventing insurance companies from rescinding coverage when
someone gets sick, eliminating lifetime limits or caps on insurance coverage, appealing
insurance company decisions, providing free preventive care, getting tough on health
care fraud, and extending the amount of time parents can cover their adult children on
their own insurance policies; many more provisions are in place today and more will roll
outthrough 2014
American Recovery and Reinvestment Act 2009 (ARRA) - Answer-Consists of 3 major
goals: create and save jobs, spur economic activity and invest in long-term growth, and
support accountability and transparency in recovery spending
Authorization - Answer-Required for any lease of patient PHI; consists of specific
elements that make it legal and appropriate to release information
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