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Revenue Management Domain 4 Exam Questions With 100% Correct Answers 2024
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Revenue Management Domain 4 Exam Questions With 100% Correct Answers
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Revenue Management Domain 4 ExamQuestions With 100% Correct Answers
Theihealthirecordireviewiprocessiandiwhatiotheriaspectiallowiforitheihig
hestileveliofiqualityiiniclinicalidocumentation?i-iCorrectiAnswer-
Physicianiqueries
TheiprimaryioperationalicomponentsiofitheiCDIiprogramiareitheirecordir
eviewianditheiqueryiprocess.iTheireviewiprocessianditheiphysicianiquer
yiprocessiallowiforitheihighestileveliofiqualityiiniclinicalidocumentationi(
Hessi2015,i158).
Aicodingiauditishowsithatianiinpatienticoderiisiusingimultipleicodesithati
describeitheiindividualicomponentsiofiaiprocedureiratherithaniusingiaisi
ngleicodeithatidescribesiallitheistepsiofitheiprocedureiperformed.iWhich
iofitheifollowingishouldibeidoneiinithisicase?i-iCorrectiAnswer-
Counselitheicoderitoistopitheipracticeiimmediately
Unbundlingiisitheipracticeiofiusingimultipleicodesithatidescribeiindividu
alicomponentsiofiaiprocedureiratherithaniusingianiappropriateisingleico
deithatidescribesiallistepsiofitheiprocedureiperformed.iUnbundlingiisiaic
omponentiofitheiNCCIiandiisiwhatitheicoderiinithisiexampleiwasidoing.iT
heiuseiofiauditsioriotherievaluationitechniquesitoimonitoricomplianceia
ndiassistiinitheireductioniofiidentifiediproblemiareasiandicorporateicom
plianceiisinecessaryitoibecomeiawareioficodingiissuesiandistopithem.iTh
eicoderiwouldineeditoibeieducatediregardingiunbundlingiandiwouldibeia
dviseditoistopitheipracticeiimmediatelyi(KuehniandiHueyi2020,i405).
,InitheiHHPPSisystem,iwhichihomeihealthcareiservicesiareiconsolidatedii
ntoiaisingleipaymentitoihomeihealthiagencies?i-iCorrectiAnswer-
Nursingianditherapyiservices,iroutineiandinonroutineimedicalisupplies,i
homeihealthiaideivisits
Underitheihomeihealthiprospectiveipaymentisystemi(HHPPS),iCMSihasia
ccountediforinonroutineimedicalisupplies,ihomeihealthiaideivisits,imedi
calisocialiservices,iandinursingianditherapyiservicesi(Castoi2018,i222).
Inireviewingiaipatientichart,itheicoderifindsithatitheipatient'sichestix-
rayiisisuggestiveiofichroniciobstructiveipulmonaryidiseasei(COPD).iTheia
ttendingiphysicianimentionsitheix-
rayifindingiinioneiprogressinote,ibutinoimedication,itreatment,iorifurthe
rievaluationiisiprovided.iWhichiofitheifollowingiactionsishoulditheicoderi
takeiinithisicase?i-iCorrectiAnswer-
Queryitheiattendingiphysicianiandiaskihimitoivalidateiaidiagnosisibasedi
onitheichestix-rayiresults
Aiqueryiisiroutineicommunicationiandieducationitooliuseditoiadvocateif
oricompleteiandicompliantidocumentation.iTheiintentiisitoiclarifyiwhati
hasibeenirecorded,inotitoicalliintoiquestionitheiprovider'siclinicalijudgm
entiorimedicaliexpertise.iThisiisianiexampleiofiaicircumstanceiwhereithei
chroniciconditionimustibeiverified.iAllisecondaryiconditionsimustimatchi
theidefinitioniinitheiUHDDSiandiwhetheritheiCOPDidoesiisinoticleari(Hun
tiandiKirki2020,i285-287).
,Duringiairecenticodingiaudit,itheicodingimanageriidentifieditheifollowin
gierrorimadeibyiaicoder.iTheicoderiassigneditheifollowingicodesiforiaifem
aleipatientiwhoiwasiadmittediforistressiincontinenceiandiaiurethralisusp
ensioniwithoutimeshiwasiperformed:i-iCorrectiAnswer-
Theicoderiassigneditheicorrectidiagnosisicodeibutiassigneditheiincorrecti
rootioperationiforitheiprocedure.
Theicoderiassigneditheicorrectidiagnosisicode.iTheicoderididinotiassignit
heicorrectiprocedureibecauseitheirootioperationiforithisiprocedureiisire
position,inotisupplement.iRepositioniisimovingitoiitsinormalilocationiori
otherisuitableilocationiallioriaiportioniofiaibodyipart,iwhereasisuppleme
ntiisidefinediasiputtingiiniorionibiologicaliorisyntheticimaterialithatiphysi
callyireinforcesioriaugmentsitheifunctioniofitheiportioniofiaibodyiparti(K
uehniandiJorwici2020,i99).
Fromitheifigure,idetermineiwhetheritheiplanicoversiGilliF.iWhite,iJane'si
spouse.i-iCorrectiAnswer-No,itheicardistatesi"Employee-Only"
Theipolicyiinformationiprovidedistatesithisiisiaisingleipolicyioriemployee
-onlyipolicy,isoitheimember'sispouseiisinoticoveredi(Castoi2018,i60).
Iniorderitoidetermineitheihospital'siexpectediMS-
DRGipayment,itheihospital'siblendedirateiisimultipliedibyitheiMS-
DRG'si________itoidetermineitheidollariamountipaid.i-iCorrectiAnswer-
Relativeiweight
, Eachidiagnosis-
relatedigroupi(DRG)iisiassignediairelativeiweighti(RW).iTheiRWiisiaimulti
plierithatideterminesireimbursement.iForiexample,iaiDRGiwithiairelativ
eiweightiofi2.0000iwouldipayitwiceiasimuchiasiaiDRGiwithiaiRWiofi1.0000
i(Hazelwoodi2020,i229).
Youiareitheicodingimanageriandiareicompletingiaireviewiofiainewicoder'
siwork.iTheicaseifactsiareithatitheipatientiwasitreatediinitheiemergencyi
departmentiforitwoiforearmilacerationsithatiwereibothirepairediwithisi
mpleiclosure.iTheinewicoderiassignedioneiCPTicodeiforitheilargestilacera
tion.iWhichiofitheifollowingiwouldibeitheicorrectiCPTicodeiassignmentif
orithisicase?i-iCorrectiAnswer-
OneiCPTicodeiaddingitheilengthsiofitheilacerationsitogether
Theilengthiofimultipleilacerationirepairsilocatediinitheisameiclassificatio
niareiaddeditogetheriandioneicodeiisiassignedi(KuehniandiHueyi2020,i82
-83).
Whichiofitheifollowingiisianiexampleiofiinternalimedicaliidentityitheft?i-
iCorrectiAnswer-
Sueiiniheriroleiasiaipatientiregistrationiclerkiusesiaipatient'siinsuranceiin
formationitoiseeiaispecialistiforicosmeticisurgery.
Medicaliidentityithefticanibeitheiresultiofieitheriinternalioriexternaliforc
es.iElectronicihealthirecordsihaveiimproveditheiabilityitoishareiinformat
ion,ibutithisihasialsoiincreasediexposureitoidataimakingiitimoreivulnerab
le.iInternalimedicaliidentityitheftiisicommittedibyiorganizationiinsiders,i
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