OIG - correct answer Office of Inspector General- established by the Dept. of Labor by the Inspector General Act of 1978 to identify fraud and abuse of
... [Show More] Medicare part A and part B programs
MAC - correct answer Medicare Administrative Contractor - used by the OIG to process claims for services rendered
Criteria for high quality documentation - correct answer 1. Legible
2. Reliable
3. Precise
4. Complete
5. Consistent
6. Clear
7. Timely
EBM - correct answer Evidence Based Medicine - the best scientific data a available for clinical documentation
Two part theory for high quality clinical documentation is derived from what - correct answer Legal/regulatory sources and peer reviewed research
Four standards used in EBM - correct answer 1. Design
2. Terminology
3. Performance
4. Procedural
DHHS - correct answer Department of Health and Human services
ARRA - correct answer American Recovery and Reinvestment Act of 2009 provides specific guidance established as part of the meaningful use incentive program
Meaningful use requirements - correct answer Provider must maintain an up to date problem list of current and active diagnoses for 80% of patients and 80% of all patients have to have at least one coded problem as opposed to their entire problem list coded
IPPS - correct answer Hospital Inpatient Prospective Payment System. Reimbursement now being driven by codes assigned to the patient stay with the inception of IPPS in 1982
House Staff - correct answer Interns, residents and fellows - physicians in training
CMS - correct answer Centers for Medicare and Medicaid Services
NCHS - correct answer National Center for Health Statistics
CMS and NCHS created what? - correct answer Both departments within DHHS, CMS AND DCHS created the Official guidelines for Coding and Reporting
Cooperating parties that developed and approved ICD-9-CM AND ICD-10-CM - correct answer AHA -American Hospital Association
AHIMA
CMS
NCHS [Show Less]