Which is an example of a diagnostic or therapeutic ancillary service provided to inpatients and outpatients?
a. laboratory test
b. blood transfusion
c. psychotherapy
d. surgical procedure
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Q. 2) Which is a hospital that provides health care services to patients who have serious, sudden, or
acute illnesses or injuries and/or who need certain surgeries?
a. acute care facility
b. behavioral health facility
c. home health agency
d. nursing facility
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Q. 3) Which was established by the federal government to define data collected for inpatient hospitalizations?
a. CMS
b. MDS
c. RBRVS
d. UHDDS
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Q. 4) The assignment of codes is based on patient record documentation by any physician involved in the care and treatment of an inpatient. However, if documentation by two or more physicians conflicts, the coder should generate a __________ to the attending physician.
a. claims submission
b. letter of appeal
c. physician query
d. remittance advice
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Q. 5) Codes may be assigned for inpatient care if they are based on other physician documentation in the patient record as long as there is no conflicting documentation from the __________.
a. attending physician
b. intern or resident
c. primary care nurse
d. utilization manager
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Q. 6) Reviewing the __________ to assign a more specific code to a documented diagnosis is considered appropriate.
a. claim submitted
b. explanation of benefits
c. patient record
d. remittance advice
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Q. 7) When inpatient record documentation appears to support the assignment of a specific code but the provider has not completely documented the diagnosis or procedure on the record's face sheet or discharge summary, the coder should __________.
a. contact the facility's billing department to request that the denied claim be appealed
b. initiate a meeting with the health information committee to resolve the issues
c. query the physician to determine whether the more specific code should be assigned
d. submit the CMS-1500 or UB-04 claim with nonspecific ICD-10-CM/PCS codes
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Q. 8) Which is the concept of assigning specific codes to conditions, procedures, or services that are not documented by the provider at that specific level of detail?
a. assumption coding
b. denying claims
c. maximizing lengths of stay
d. optimizing reimbursement
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Q. 9) Coders are __________ assign codes when the provider does not specifically document those diagnoses, procedures, and/or services.
a. allowed to
b. encouraged to
c. prohibited from
d. required to
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Q. 10) When assigning codes, coders carefully review __________ to locate conditions, diseases, procedures, and services to which codes are assigned.
a. claim submitted for reimbursement
b. explanations of benefits
c. remittance advice documents
d. reports in patient records
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