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CDI
Compliance/Legal/Ethics
Revenue Cycle
Information Governance
Coding/ICD-10
100
This is generated when health record documentation is conflicting, imprecise, incomplete, illegible, ambiguous, or inconsistent.
What is a query?
100
Control over the use and disclosure of the information contained within the health record regardless if it is paper or electronic lies with this person or entity.
What is the patient?
100
This is a classification system that groups patients according to diagnosis, type of treatment, age, and other relevant criteria.
What is diagnosis-related group (DRG)?
100
This association is leading “Information Governance” for healthcare.
Who is AHIMA?
100
Although there were multiple delays, this was the final implementation date for ICD-10-CM/PCS.
What is October 1, 2015?
200
This is an individual who assists in communicating and education medical staff in documentation procedures.
What is physician champion (advisor)?
200
Under HIPAA, this is also known as the “need-to-know” principle.
What is minimum necessary?
200
This Act has been a catalyst for the transition to pay for outcomes.
What is the Affordable Care Act (ACA)?
200
This is the most common reason HIM professionals have reported as the reason to start an IG program.
What is identifying issues with the EHR?
200
Outpatient services are reimbursed based on this coding system.
What is CPT?
300
This is the number of query responses divided by the number of queries sent.
What is the query response rate (QRR)?
300
Every organization must have this plan implemented to protect patient safety, secure health information from damage, ensure stability in continuity of care activities, and provide for orderly recovery of information when needed.
What is the comprehensive disaster/recovery plan?
300
This PPS system is used in inpatient rehabilitation facilities.
What is IRF-PPS?
300
The Information Governance program should align with these types of goals.
What are organization’s goals?
300
This coding system is used to bill for durable medical equipment and medications.
What is HCPCS (Level II)?
400
This code set does not have an unspecified code option.
What is ICD-10-PCS?
400
These are penalties or other methods of enforcement used to provide incentives for compliance with organizational policies and procedures.
What is sanctions?
400
This is defined as the process for extracting and translating transcribed free-text data or computer-generated discrete data into codes (ICD-9-CM, ICD-10-CM/PCS and/or CPT/ HCPCS) for billing and coding purposes.
What is Computer-assisted coding (CAC)?
400
This is the reason that IG is needed now in healthcare with ever-evolving and growing technologies.
What is big data?
400
Hospitals utilize this coding system for inpatient procedures.
What is ICD-10-PCS?
500
This is the CMS program that replaces the Medicare Program Safeguard Contractors (PSCs).
What is Zone Program Integrity Contractor (ZPIC)?
500
Patient requests to PHI must be responded to within this timeframe.
What is 30 days? (Bonus: They have 30 days with one 30 day extension as long as they notify the individual.)
500
The program’s mission is to identify and correct Medicare improper payments.
What is the Recovery Audit Program or Recovery Audit Contractors (RAC)?
500
This is how to show quantifiable successes with your IG program.
What are defined measures and dashboards?
500
This coding system is not used by coders, but is used in EHRs and mapped to ICD-10 codes.
What is SNOMED (or SNOMED-CT)?