Critical Thinking Questions

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Black Hawk College *

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156

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Mechanical Engineering

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Dec 6, 2023

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pdf

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Uploaded by BailiffRain12419

Critical Thinking Questions Chapter 12 1. Match each credential on the left with the granting organization on the right. CCDS ______ a. AAPC CCS-P ______ b. ACDIS CPC ______ c. AHIMA 2. What are some characteristics of an experienced coding professionals? 3. How does the use of an encoder support revenue integrity? 4. What role do coding professionals have in the CAC process? 5. What factors should be considered when determining coding productivity measures? 6. Define DNFB. 7. What are the seven characteristics of high-quality documentation? 8. Describe the three main functions included in CDI. 9. What is the role of queries in the CDI process? 10. Which CDI metric measures the percent of time a physician responds to a CDI query? B C A - Has coded at least 1 year in area of practice - Have a coded credential - Proficient in same day surgery/complex ambulatory coding. - Limited exposure to inpatient coding - Meets productivity and accuracy measures Increases consistency and efficiency of the coding process by prompting the coder with queries that follow ICD-10-CM and PCS coding conventions and guidelines. Review the suggested codes, accept or reject them, and add any missing codes. Cross-check the codes against standards and quality metrics. Determine the final code selection based on their knowledge of coding guidelines, clinical concepts, and compliance regulations. - Facility influencers - Coding professional influencers - Medical record influencers Discharged, not final billed A measure of the health of the claims generation process; displayed in days or dollars. If coding productivity is reduced, the DNFB could rise because medical records are not being coded and cannot be released for claim submission to the payer. 1. Clear 2. Complete 3. Consistent 4. Legible 5. Precise 6. Reliable 7. Timely 1. Record review: Use CAC list to locate conditions that may have low-quality documentation, Establish and update working MS-DRG, Determine/update SOI level, Determine /update ROM level. 2. Query for Clarification: Concurrent while patient is still in the hospital, Query throughout the admission as warranted, Unanswered query can be submitted a final time post-discharge. 3. Physician Education: Work with physicians to help them understand why documentation is deficient and what documentation is required for coding. - Improve the accuracy, completeness, and specificity of medical documentation - Ensure that documentation accurately reflects the patient's condition - Ensure accurate code assignment for an individual encounter - Help improve patient care and outcomes - Ensure accurate reimbursement Physician response to CDI specialist rate

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