solution

Which reimbursement methodology is used in IPPS?

2. Which SOI level is reflected by CC codes? Which SOI level is reflected by MCC codes?

3. Fatima is calculating the MS-DRG for an inpatient admission. She has determined that the encounter does not qualify for pre-MDC assignment. What is the next step in the MS-DRG assignment process?

a. determine the MDC for the principal diagnosis

b. Determine the MDC for the principal procedure

c. Determine if the case is medical or surgical

d. Determine if there is a CC in the secondary diagnosis position

4. Eli is calculating the MS-DRG for an inpatient admission. He is determining if the encounter is medical or surgical. Which of the following should he do?

a. Determine if the physician dictated an operative report for the principal procedures, if so, then the encounter is surgical

b. Determine if the principal procedure is an OR procedure in the MS-DRG Definitions Manual

c. Determine if any procedure reported, principal or secondary, is an OR procedure in the MS-DRG Definitions Manual

d. Look at the encounter charges and see if there are any OR charges 5. Which provision provides additional reimbursement for new technologies that enhance beneficiary outcomes?

6. Why does the IME adjustment add reimbursement for teaching facilities?

7. What are the four domains used in the Hospital VBP program?

8. Discuss the importance of the present on admission (POA) data element in the HAC POA program

9. One of the two domains in the HAC reduction program tracks healthcare-associated infections (HAI). Name two measures used in this domain.

10. List a focus of the Hospital Readmissions Reduction Program (HRRP).