Organization
What is EMTALA?
What is Emergency Medical Treatment and Active Labor Act
What day is ICD-10 in effect?
When is October 1.
Which HIM team releases health information to requestors?
What is Release of Information.
Ensure the quality of medical records by verifying their completeness, accuracy, and proper entry into computer systems.
What is RHIT
Which of the following creates a chronological report of the patient’s condition and response to treatment during a hospital stay?
What is a Progress Note
What does AHIMA stand for?
What is American Health Information Association
Which organization maintains the CPT?
What is AMA
Which team gathers charts for clinics?
What is Health Information Technicians
Skilled in classifying medical data from patient records, generally in a hospital setting. Review patients’ records and assign numeric codes for each diagnosis and procedure
Possess expertise in the ICD-10-CM and CPT coding systems
What is a CCS
This document serves several purposes. It is an important reference document that provides concise information about a patient's findings at the time of admission
What is a History and Physical Report
What is the practice of acquiring, analyzing, and protecting digital and traditional medical information vital to providing quality patient care. It is a combination of business, science, and information technology
What is Health Information Management (HIM)
Who is responsible for publishing and maintaining HCPCS level II
What is Center for Medicaid and Medicare Services (CMS)
A medical document that gives information about a diagnosis. To test for the disease, a sample of your suspicious tissue is sent to a lab.
What is a pathology report
They ensure accuracy and quality among medical coders, doctors, nurses, and other healthcare staff. They maintain charts, medical records, and reports and solve any issues involving documentation
What is a Clinical Documentation Improvement Specialist
The organization that accredits HIM education programs is:
What is CAHIIM
What is the term where diagnosis are captured by artificial intelligence?
What is Computer Assisted Coding
A form that includes the relevant clinical indicator(s) that show why a more complete or accurate diagnosis or procedure is requested.
What is a Query
Is an expert in managing patient health information and medical records, administering computer information systems, collecting and analyzing patient data, and using classification systems and medical terminologies
What is RHIA
This is a specialized skill that requires knowledge of medical terminology, anatomy, physiology, disease processes and analytical skills, assigns codes and procedures for these diagnoses based on ICD-10CM or PCS conventions and standards.
Who is a Clinical Coder
What is AHIMA Mission?
Provide education, research, and professional credentialing.
What is the definition of principal diagnosis?
What is the condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital?
What are three examples of covered entities that are considered and EHR or a Healthcare Clearing House?
What is Billing services, CERNER, MEDITECH, McKesson, 3M, Ingenix, or 3M.
Knowledgeable and competent in high-quality clinical documentation within patient health records
What is CDIP