Hospital Terminology
What does the acronym NPO stand for?
What is "Nothing by Mouth"
This front-end process involves collecting patient insurance information and verifying eligibility before services are provided.
What is "Registration or Insurance Verification"
This federal agency oversees Medicare and Medicaid and sets many of the rules for reimbursement in the U.S.
What is "CMS (Centers for Medicare & Medicaid Services)"
This type of exercise, like walking or running, helps improve heart health and endurance.
What is "Cardio (Cardiovascular Exercise)"
This planet is known as the “Red Planet” because of its reddish appearance from iron oxide on its surface.
What is "Mars"
What is the Latin phrase for immediately, often used in emergencies?
What is "STAT"
This standardized coding system is used to report diagnoses on claims and impacts risk adjustment and reimbursement.
What is "ICD-10-CM"
This CMS payment system assigns hospital inpatient stays into groups based on diagnoses, procedures, and severity of illness.
What is "MS-DRG (Medicare Severity Diagnosis-Related Group)"
This vitamin, often called the “sunshine vitamin,” is produced in the skin when exposed to sunlight.
What is "Vitamin D"
This animal is the only mammal capable of true sustained flight.
What is a "Bat"
What acronym stands for as needed or as required?
What is "PRN"
This post-service process ensures documentation supports billed services and often identifies missed CCs/MCCs.
What is "Coding (or Clinical Coding Review)"
This CMS program reduces hospital payments for excessive readmissions for certain conditions, like heart failure and pneumonia.
What is "The Hospital Readmissions Reduction Program (HRRP)"
This body system includes the brain and spinal cord and controls most functions of the body.
What is "Nervous System"
Sharks are older than this natural structure, having existed over 400 million years ago.
What is "Trees"
This program is intended to increase access to primary care in rural communities. To receive certification, they must be located in rural, underserved areas.
What is "A rural health clinic."
This denial occurs when a service is billed without obtaining required approval from the payer beforehand.
What is a "Prior Authorization Denial"
This CMS initiative ties hospital reimbursement to quality outcomes, including patient safety and experience measures such as HCAHPS scores.
What is "The Hospital Value-Based Purchasing (VBP) Program"
This term refers to the practice of being fully present and aware, often used to reduce stress and improve mental health.
What is "Mindfulness"
This ocean is the largest on Earth, covering more surface area than all land combined.
What is the "Pacific Ocean"
This suffix means “surgical removal,” commonly used in procedures that impact procedural coding and billing.
What is "-Ectomy"
This revenue integrity concept refers to ensuring that documentation, coding, and billing accurately reflect the patient’s severity of illness, directly impacting MS-DRG assignment and reimbursement.
What is "Clinical Documentation Integrity (CDI)"
Under CMS guidelines, this concept ensures that documentation supports the medical necessity of services, a key factor in preventing denials and audits.
What is "Medical Necessity"
This condition, often linked to poor sleep or stress, occurs when the body produces too much cortisol over time, impacting overall health.
What is "Chronic Stress (or Prolonged Stress Response)?
Octopuses have three of these, which help them efficiently pump blood throughout their bodies.
What are "Hearts"