2024 Hospital Clinical Documentation Improvement: Stating the Correct Clinical Picture (33) – Post Test

1. Which statement is false regarding a DRG? A DRG …

2. Which of the following is a Major Comorbid Condition (MCC)?

3. In 2022, a new HEDIS measure on care transitions was released. Two areas of focus for this transitions of care measure are

4. True statements about the length of stay measure metric include (select ALL that are correct)

5. Using “presumed” or “likely” pneumonia diagnosis gets coded as

6. The Principal Diagnosis (reason for admission) and all secondary diagnoses (impacting condition) and procedures related to the admission come together to make the

7. If a patient has aspiration pneumonia, add which of the following to enhance the DRG? Choose ALL that are correct.

8. Your system has undertaken an effort on “medical necessity documentation capture” and found that there is a significant number of “day 2 and 3 Observation” patients with COPD exacerbation that were still clinically unsafe for discharge. Since they were still getting active management with documentation to support, the Physician Advisor Team members have been recommending that these patients be ordered inpatient until safe for discharge. These recommendations are coming late on day 2 or early on day 3 of the hospital stay.  Additionally, there was a wave of Norovirus that spread through the region for about six weeks with similar clinical manifestations (OBS on late day 2 with active management à change to IP until stable).  The surgery volume/types for this past month are in line with budget predictions. 

Given this influx of “medical IP cases”, you surmise that the Case Mix Index for this month….

9. Choose the condition coded to the highest level of severity

10. To capture the highest level of severity for a condition, link the diagnosis to causation with comments such as