You have been asked to write a report that includes information about chart episodes for hospital encounters.
Which of the following correctly illustrates how to link a chart episode with the primary encounter associated with the episode? Choose ALL that apply.
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You have been asked to write a report that includes information about a chart episodes for hospital encounters.
In addition to CT_EPISODE and PAT_ENC_HSP, which table is needed to link a chart episode with all of the associated encounters? Choose only ONE answer.
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| T/F: to report on delinquency rates by location, you can use the LOC_ID column in CLARITY_DEF. |
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| False. Location is not a required item when creating a deficiency definition. A single dificiency definition can be used by multiple locations. |
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| What fields are used to link deficiency instance records to the records for the assigned parties? |
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DFI_DETAILS.DFI_ID is used to link to CT_DEF_MULT_STAFF.DFI_ID
CT_DEF_MULT_STAFF.ASGN_PROV_ID is used to link to CLARITY_SER
CT_DEF_MULT_STAFF.ASGN_POOL_ID is used to link to CLARITY_HIP |
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| An _________ is created for each hospital encounter to store information about the encounter's deficiencies. |
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| A _____________ is an incomplete or missing peice of documentation in a patient's chart that is required for billing, compliance, or other purposes. |
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| What is stored in Chronicles as item number CHT 1550? There are four possible values for this item: 1-Closed, 2-Open, 3-Voided, and 6-Addendum Added. These values can be set in Hyperspace in the Deficiency Complaetion activity. |
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| This item is updated in Chronicles only when the epoisode is closed. |
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| Chart Episode Deliquency Status (EPISODE_DLQ_YN) |
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| If two actions occured at the same time down to the second, how can twe distinguish which action happened first? |
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| The earlier action will have a smaller value in the LINE column. |
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| Why are the DFI_AUDIT_TRAIL and F_DT_ASGN_STAT tables better for historical reporting on assigned staff than the CT_DEF_MULT_STAFF table? |
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| The CT_DEF_MULT_STAFF table clears out information as the assigned party changes, so it only shows information as of the last Clarity extract. |
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| Actions taken on deficiency instances are extracted to the _______________ table. |
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| Episode Actions are stored in the ______________ table. |
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| What two actions cause the PRIV_AUD_SUSLINE columns to be populated in PROV_PRIV_AUD_TRL? |
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| You are running a daily report that shows you how many delinquent deficiencies a provider has yet to address. You see a number of providers who have delinquent deficiencies that are not being taken care of. What table can you use to incorporate wheterh or not the provider was in the office ona particular day? |
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| What table holds informations related to all of a provider's admitting and attending suspensions? |
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| THis table contains one row of audit information for each change in a provider's HIM status. |
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| Out-of-Office details are stored as records in the _____________ master file. |
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| Why would you use the HSP_ACCT_DX_LIST table in a report? |
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| To report on the coded final diagnoses on a hospital account. |
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| Which table would you use to see all DRG codes entered on a hospital account? |
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| Why is having a LINE value of 1 significant for a record in the HSP_ACCT_PX_LIST table? |
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| This indicates the procedure is the primary procedure on the account. |
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| The ________ process is the process of getting the chart ready to be sent as a claim. Generally, it involves collecting and classifying several areas of information: ADT information (where did the patient come from, where did they go, and who cared for them while they were here), diagnoses, procedures, and diagnoses related groups. |
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| Insurers need to see diagnoses reporesented as a discrete code that they can feed into their reimbursement system. What is the ninth revision of this code? |
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ICD-9
(International Classification of Diseases) |
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| Insurers need to see diagnoses reporesented as a discrete code that they can feed into their reimbursement system. What is the tenth revision of this code? |
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ICD-10
(International Classification of Diseases) |
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| A _____(X)_____ contains information and identifiers for billing purposes. However, ____(X)_____ do not necessarily lend themselves well to clinical use. |
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| Code-Type Diagnoses Record |
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| _______________ are the clinical-freindly words used to describe problems. A term record can link to one or more codes from multiple code sets. |
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| Term-Type Diagnoses Record |
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| A ________________ exists as a term, and it directly corresponds to an ICD code with the same diagnosis name. I the EDG master file, this would me represented as a single record. |
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| Both-type diagnoses record |
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| ______________ is the process of entering data into accounts primarily for reporting purposes. |
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| If an account has two rows where the status history was set to Complete, what does that usually represent? |
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| A manager has gone in to review the coder's work. |
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| What is one example of a DNB? |
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| The most important DNB chech is when programming point 414165-Coding Status Complete Check is added. This is set for accounts that have been discharged cut not billed and coding has not been finished within a sufficient number of days after discharge. |
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| If a coder has more questions about the work performed by the treatment team they can request more information by sending a ____________. |
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| ______(X)______ serve a purpose very similar to billing indicators, but are specific to hospital coding. ___(X)___ allow users or the system to automatically mark hospital accounts as needing follow-up for a variety of reasons and allows an easy way to drive workqueues to track and resolve issues. |
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| These are a type of edit that are placed on a hospital account in order to prevent any bills or claims from being processed for those accounts and can be added to an account manually or automatically by the system. |
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| These are a type of edit that are placed on a hospital account in order to prevent any bills or claims from being processed for those accounts and is added by the system automatically. |
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| How is each new CDI review stored in Chronicles and in Clarity? |
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| A new contact in the COD master file and a new row in COD_CONTACT_INFO. |
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| What column distinguishes Coding queries from CDI queries? |
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| CODING_CLA_NOTES.QUERY_WORKFLOW_C |
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| The ____________________ process is a program by which someone with a degree os familiarity with both clinical care and coding processes reviews the documentation currently present on a stay and checking to see if enough detail is present to code to the specificity desired. |
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Clinical Documentation Improvement
(CDI) |
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| Someone with a degree of familiarity with both clinical care and coding processes may determine that more information is required, they can send queries to the appropriate memebr of the treatment team requesting more detail. This could occur during what process? |
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| What table contains information related to Working Diagnoses for a CDI review? |
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| What table contains information related to working procedures for a CDI review? |
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| What table contains information about the DRG data stored as part of a CDI review? |
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| Which table contains information on queries sent during coding (including Missing Documentation flags) and CDI reviews? |
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| These are edits placed on hospital accounts in order to prevent any bills from being processed for those accounts. These are only added by the system. |
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Dishcharge Not Billed
(DNB) |
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| How is each new CDI review stored in Chronicles and in Clarity? |
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| As a new contact in the COD master file and a new row in COD_CONTACT_INFO. |
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WHat column distinguishes Coding queries from CDI queries?
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| CODING_CLA_NOTES.QUERY_WORKFLOW_C |
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| A program by whihc someone with a degree of familiarity with both clinical care and coding processes reviews the documentation currently present on a stay and checking to see if enough detail is present to code to the specificity desired. |
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| Clinical Documentation Improvement |
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| This activity exists in Hyperspace for a staff member to review and query (if further information is required) diagnosis and procedure information relating to a hospital encounter. |
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| If during the course of reviewing the documentation the reviewer decides more information is required, they can inquire with the appropriate member of the treatment team requesting more detail. What process is this? |
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| Name an example of and external user, and internal user, and a user that could be both. |
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| An external referring provider, a report writer (or a coder), and a physician employed by Jefferson would be considered both. |
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| What does SER stand for within the SER Master File? |
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| Scheduable Epic Resources |
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| In the CLARITY_SER table, which column should you use to determine the type of resource? |
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PROV_TYPE
Ex: Resource, Physician, Registered Nurse, Pharmacist, etc.
(STAFF_RESOURCE_C indicates person, resource or class)
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| T/F: In the ROI_DETAILS table, the column ROI_ID is the internal ID ONLY and should NOT be displayed on reports. |
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| False, the ROI_ID is also the External ID and can be displayed on reports |
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| T/F: In the ACCOUNT table, when the ROI_PAT_ACCNT_YN is populated with a Y it is an ROI patient account, when it is populated with a N it is a non-patient ROI account, and will be null it is not an ROI account (Guarantor Account). |
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| T/F: In the ROI_AUDIT_TRAIL table, the LINE number indicates the order of the actions that occured on a Release Record. |
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| True, if the LINE = 1 this would give you information about how the ROI was created. |
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| When dificiencies expire, what do they become? |
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| Which master file and Clarity table contains basic information about deficiencies such as deficiency definitions? |
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| DEF Master File and CLARITY_DEF |
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| A delinquency can be delinquent if one of two conditions are met, name them. |
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1. It is not complete or closed by an administrator and the DELINQUENCY_DATE is in the past.
2. It is complete, but the COMPLETED_DATE was after the DELENQUENCY_DATE. |
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| T/F: If a deficiency can be associated with a chart episode, it has the classification of Episode Ba sed. If it can be used with clinical workflows, it has a classification of Clinic. |
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| These types of actions are extraced to the CT_EPSD_AUD_TRAIL table. |
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| These types of actions are extracted to DFI_AUDIT_TRAIL. |
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| Delinquency-Level Actions |
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| T/F: A provider's suspension begins when the value in the Suspend? field is changesd to Yes and lasts until the field is changed back to No. |
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| In Hyperspace, what form allows you to change the admitting and attending privileges for a provider? |
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| Which table contains one row of audit infomation for each change in a providers HIM status? |
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| What is the process of getting a chart ready to be sent as a claim by collectins and classifying ADT information? |
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| These diagnoses type records contain information for billing purposes, but they do not necessarily lend themselves well to clinical use. |
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| Code-type diagnosis record |
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| What types of diagnosis records are clinical friendly, but lack the detail for billing purposes? |
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| Term-type diagnosis record |
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| What type of diagnosis record exists as a term, and it directly corresponds to an ICD code with the same diagnoses name? |
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| Both-type diagnosis record |
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| These are used to describe the 'products' a healthcare provider has provided. An exaample of a 'product' would be an Appendectomy. |
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Diagnoses Related Group
(DRG)
https://en.wikipedia.org/wiki/Diagnosis-related_group |
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| What is the process of entering data into accounts primarily for reporting purposes? |
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| What allow a coder to enter additional details regarding a coded procedure, especially regarding anesthesia? |
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| If a coder has questions about the work performed by a treatment team, the can request more information by sending what to the provider? |
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| These allow users or the system to automatically mark hospital accounts as needing folowing up for a variety of reasons and allows an easy way to drive WQ's to track and resolve issues. |
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| What is placed on a hospital account in order to prevent any bills from being procesed that can be added by the ssystem or a user, but can only be removed by a user? |
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| What is placed on a hospital account in order to prevent any bills from being procesed that are added by the system, but can be removed by a user or the system? |
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Discharge Not Billed
(DNB) |
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