Term
| Medicare Severity Diagnosis Related Groups |
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Definition
| What does MS-DRG stand for? |
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Term
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Definition
| For the 2008 FY, the DRG system was refined to the _____ system |
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Term
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Definition
| Federal fiscal years begin on _______ and end on ______. |
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Term
| major complication or comorbidity |
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Definition
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Term
| regular complication or comorbidity |
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Definition
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Term
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Definition
| ______ established a new three-tiered payment system for DRGs that distinguished between a MCC, C/C, or no complication or comorbidity. |
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Term
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Definition
| After admission, the patient develops a catheter-associated UTI. This is an example of a ___________. |
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Term
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Definition
| A patient was admitted for pneumonia with pre-existing chronic systolic left heart failure. This is an example of a ________. |
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Term
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Definition
| T or F: MS-DRGs payment rates to hospitals are affected depending on where a patient is discharged to (home, nursing home, etc.) |
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Term
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Definition
| _________ represent classifications of diagnoses in which patients with similar conditions within the same group will consume similar types and amounts of hospital resources |
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Term
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Definition
| T or F: Payment systems will be linked on positive patient outcomes for their severity of illness level |
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Term
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Definition
| a software application that assigns MS-DRGs. |
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Term
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Definition
| What a relative weight is multiplied against; it reflects individual hospital monetary adjustment factors for geographic status |
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Term
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Definition
| T or F: A hospital's location will not affect its reimbursement rate |
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Term
False
MS-DRGs control provider's ways of utilizing resources by setting limits |
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Definition
| T or F: MS-DRGs tell providers how to practice medicine |
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Term
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Definition
| T or F: Coding is used to determine and plan for the types of services that are needed within communities |
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Term
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Definition
| T or F: Coding can help develop and implement local, state, and national health care policy (such as cessation of smoking) and to determine mechanisms to contain health-care costs |
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Term
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Definition
| T or F: Coding ensures disease management through various health-care settings (i.e. a patient's information will follow them from a doctor's office to a hospital). |
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Term
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Definition
| a daily publication of the federal government that contains proposed rules, public notices, and federal agency regulations--as well as each year's new and revised codes |
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Term
| alphabetical index, tabular |
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Definition
| A coder must look up a disease or procedure in the ________ and then numerically in the ________ section |
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Term
False
A coder should code to the highest level of specificity |
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Definition
| T or F: A coder should always code to the lowest level of specificity |
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Term
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Definition
What codes have the highest level of specificity?
a) two digit
b) three digit
c) four digit
d) five digit
e) all of the above
f) c for procedures, and d for diseases |
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Term
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Definition
| Three digit codes are ______ codes. |
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Term
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Definition
| Four digit codes are _______ codes |
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Term
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Definition
| Five digit codes are _________ codes. |
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Term
| When they are not further subdivided |
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Definition
| When are three digit codes assigned? |
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Term
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Definition
| The Alphabetic Index to External Causes of Injury and the Table of Drugs and Chemicals are found in volume ___. |
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Term
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Definition
| T or F: V codes cannot be used as a principal diagnosis |
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Term
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Definition
CODE
Admission for chemotherapy |
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Term
| reason for contact with health services |
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Definition
| V codes are used as a principal diagnosis when describing ___________. |
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