Soi severity of illness - Study guides, Class notes & Summaries

Clinical Documentation Toolkit What is CDI? - Any manual or electronic notation made by a clinical care provider or their authorized "medical scribe." What is the purpose of CDI? - The diagnosis and procedures documented in the record need to be clearly supported by clinical indicators so that the ICD-10-CM/PCS codes assigned are accurate and correctly assigned. Written Query - The method of clarification used by CDI professionals. Verbal and electronic are also methods documented in t...

CMS - Answer Centers for Medicare and Medicaid Services OIG - Answer Office of Inspector General BoK - Answer Body of Knowledge HHS - Answer Health and Human Services MS-DRG - Answer Medicare Severity-Diagnosis Related Group Ethical query - Answer Query that is open ended and does not lead the provider towards a specific answer HAC - Answer Hospital acquired condition Appropriate documentation - Answer an accurate depiction of what is actually occurring with ...

Urosepsis - Infection confined to the urinary system. Refers to pyuria or bacteria in the urine (not in the blood). Query the physician to determine if the bacteria in the urine has progressed to septicemia or sepsis. What year was TEFRA (Tax Equity and Fiscal Responsibility Act) implemented? - 1982 Query process and procedure should address: - 1. When queries will be asked. 2. Who will ask queries and to whom queries will be asked. 3. The hospital's responsibility in supporting the queri...

Consistent - the record is not contradictory Complete - the record has the maximum content and is thorough If you have two conflicting diagnoses by two providers, who should make the final decision? - Attending physician Hospital Acquired Conditions - conditions that will not be reimbursed if they occur in the hospital after admission Concurrent reviews - CDI specialist reviews the patient record while the patient is in the hospital Ethical Queries - Queries that do not lead the physician...

CDIP Domain 1 Clinical Coding PracticePrincipal Diagnosis - correct answer The disease or condition that was present on admission, was the principal reason for admission, and received treatment or evaluation during the hospital stay or visit for the reason established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care First Listed Diagnosis - correct answer Used in the outpatient setting, this term is used (instead of the inpatient sett...

Coding Clinic Valuable reference tool for coders that is published by AHA each quarter CPT Current Procedural Terminology Brainpower Read More MS-DRGs Medicare Severity-Diagnosis Related Groups CPT Assistant Monthly publication by the AMA that provides coding advice for CPT coding scenarios Encoder Nosology Provides coding professionals from the encoder company that are available to help answer tough coding questions History & Physical Provides the in...

CDIP Domain 4 CDI Metrics and StatisticsDenial Rate - correct answer Number of Claims or line items denied / number of claims or lines items submitted Query Response Rate - correct answer Number of Query Responses / Number of Queries Written Escalation Policy - correct answer Provides a specific list of management and other authorities that must be contacted in the event of no response who works the working DRG - correct answer Clinical documentation specialists Who assigns the fi...

CDIP Toolkitrecent drivers of CDI (p2) - correct answer - MS-DRGs 2007 to reflect SOI/ROM - POA indicators 2008 - Medicare Advantage/Part C (capitated, HCC) - some payers moving to APR DRGs - compliance reviews: RAC, Zone Program Integrity Contractors, Medicaid Integ Contractors purpose of CDI program (p2) - correct answer to initiate concurrent and, as appropriate, retrospective reviews of health records for conflicting, incomplete, or nonspecific provider documentation. goal of CDI ...

CDIP EXAM QUESTIONS 2024. Cert - correct answer Comprehensive error testing rate Cpt - correct answer Current procedural terminology. The amas list of 5 digit codes used to report outpatient hospital and Physicians Medical and surgical services. CPT is used to report outpatient or Physician Office claims only and is updated annually in January. Hac - correct answer Hospital-acquired conditions are defined as for discharges occurring on or after October one 2008 ipps hospitals will not rec...

CPB Certified Professional Biller Certification exam questions with correct answers Abuse - Correct Answers-Actions inconsistent with accepted, sound medical business or fiscal practice Accept Assignment - Correct Answers-Provider accepts as payment in full whatever is paid on the cliam by the payer (except for any copayment and or coinsurance amounts.) Accounts Receivable - Correct Answers-The amount owed to a business for services or goods provided. Accounts Receivable Aging Report - Corre...