Coding
Compliance (general)
Electronic Health Record(s)
Meet the Team
Hospital Related
100

A coding system used by healthcare providers to classify and code diagnoses, symptoms, and procedures for claims processing, health statistics, and research, ensuring consistent data collection and analysis globally

What is ICD-10 (International Classification of Diseases)?

100

The chief corporate compliance officer at MCW holding the VP title for Corporate Compliance and Risk Management

Who is Tennille Sifuentes?

100

The electronic health record the Medical College of WI and FTCH utilize 

What is EPIC?

100

Manager of Clinical Compliance at MCW

Who is Karen Rhyner?

100

A person who is a healthcare professional trained in the use and administration of medications

What is a pharmacist?

200

Is divided into broad categories such as office visits, hospital inpatient or observation care visits, and consultations

What are Evaluation and Management (E/M) Services?

200

A way to anonymously report a concern

What is the Compliance Hotline?

200

A system used to monitor access to electronic health records

What is Protenus?

200

Is the newest member of the Clinical Compliance team at MCW

Who is Hannah Moreno, Compliance Education Coordinator?

200

A person who operates on patients to treat injuries

What is a surgeon?

300

A coding system used by the American Medical Association (AMA) to assign codes for medical procedures and services, ensuring accurate and standardized reporting for billing and administrative purposes

What is CPT (Current Procedural Terminology)?

300

There are seven elements to an effective compliance program according to this group

What is the OIG (Office of Inspector General)?

300

The number of days a clinician has to close an encounter 

What is 10 days?

300

Has worked at the Medical College of Wisconsin the longest

Who is Georgia Dollhopf, Compliance Coordinator lll?

300

A person typically referred to as "house staff" in a hospital setting supervised by an attending physician

What is a resident?

400

Two-digit codes appended to CPT codes to provide additional information about a procedure or service, without changing the code’s meaning, and are used to communicate specific circumstances to payers

What are modifiers?

400

A form used to inform a patient that Medicare may or may not pay for service

What is an ABN (Advanced Beneficiary Notice of Non-coverage)?

400

The regulation guiding encounters to be closed

What is information blocking?

400

Does investigations for Clinical Compliance

Who is Leslie Lauren, Compliance Coordinator lll & Special Investigations of HIPAA breaches and OTH?

400

A federal law that requires hospitals participating in Medicare to provide a medical screening examination and stabilizing treatment to anyone who comes to the emergency department regardless of insurance status or ability to pay

What is EMTALA (Emergency Medical Treatment and Labor Act)?

500

A standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes

What is HCPCS (Healthcare Common Procedure Coding System)?

500

Medicare document that can be used to determine the RVU value of a CPT code

What is the physician fee schedule?

500

When an employee accesses protected health information for non-business purposes

What is a HIPAA privacy violation?

500

The radiology expert for the team

Who is Breanna Suskey-Payton, Compliance Coordinator lll?

500

A physician who self-refers violates this law

What is the Stark Law?