Classification systems and secondary data sources Flashcards
Meme common prescription given for glaucoma
Pilocarpine
What type of conditions is digoxin prescribed?
Maintenance therapy in congestive heart failure or atrial fib atrial flutter paroxysmal atrial
tachycardia
Which classification system was developed to standardize terminology and codes used for clinical laboratories?
LOINC codes
Which classification system is used to classify neoplasms according to site, morphology, and behavior?
International classification of diseases for oncology ICD –o
Which classification system was designed with electronic systems in mind is currently being used for problem lists, ICU UNIT monitoring, medical research studies, clinical trials, disease surveillance, and images?
SNOMED-CT
The cancer program is surveyed for approval by what buddy?
The commission on cancer of the American College of surgeons
what organism is significant of Graham negative pneumonia?
Pseudomonas
A procedure which is discontinued due to a patient’s difficulty during surgery is reported with what modifier?
53
Name one barrier to widespread use of automated code assignment
Poor quality of documentation
What modifier is commonly used for return to surgery which is unplanned and during the global period of another surgery
58
What is the primary goal of A hospital based cancer registry?
To improve patient care
Name the population-based cancer registry it is designed to determine rates and trends in a defined population
Incidence only population-based registered
What is required for billing and inpatient CPT consultation code
The physicians documentation of his findings in the patient’s medical record
If a specialist consult with an inpatient one day and another day returns to follow up with the patient, what codes would you bill?
Initial consult day one, subsequent hospital day two
Where’s the best place to determine the size of an excise lesion for accurate CPT coding?
The operative report
What type of code and it was a hospital to go to more specific information for use in patient care benchmarking quality assessment research public health reporting strategic planning and reimbursement?
ICD 10 CM
Name one important criterion for assessing the case in the birth defect registry
Age
To obtain information collected during a specific time. In your hospital which registry would be the most helpful
Accession registry
What is the reference date for cancer registry?
The date when the data collection began
What type of information is collected as part of the trauma Registry
Patient demographics, prehospital interventions, vital signs on admission, procedures and treatment prior to hospitalization, transport modality, and injury severity score
What is an active surveillance system?
One that uses train staff to identify cases in all hospitals clinics and other facilities through reviewed patient records, indexes, vital records, and hospital logs
Describe coding reliability
When the same codes are obtained by different coders or by the same code her on multiple attempts
What is the health care cost utilization project? (HCUP)
A set of databases that include data on in patients who cares paid for by third-party payers
HCUP is initiative of which agency
Agency for healthcare research and quality
For accurate coating of a skin graft which site is an essential?
The recipient site
What is the method of calculating errors in a coding on it that allows for benchmarking with other hospitals and permits the reviewer to track Errors case by case?
Record over record method
What is most common type of registry located in hospitals of all sizes and every region of the country
Cancer registry
What is the primary responsibility of the cancer committee?
To establish quality improvement priorities of the cancer program and monitoring effectiveness of quality improvement activities
According to CPT antepartum care includes what?
Initial subsequent history, physical examination, between chemical analysis,
What would be a good resource for comparing long-term survival rates of a specific cancer in patients treated surgically versus medically?
Cancer registry abstracts
Define clinical vocabulary
A list or collection of clinical words or phrases with their meaning
Name one procedure conducted to facilitate eating
PEG
What is the name for the route operation that describes cutting out or off without replacing a portion of a body part?
Excision
If No bilateral code is provided in the condition is bilateral so should you Code?
Assign separate codes for both the left and the right side
Name the special form which plays a central role in planning and providing care nursing, psychiatric, and rehab facilities
The interdisciplinary care form
Which codes SET is used for proper reimbursement and MS-DRG
ICD-10 and PCS
