CRCR - Certified Revenue Cycle Representative Program Charge Capture and Coding Questions and Answers

Question 1

A hospital's Charge Description Master (CDM) is a critical component of the revenue cycle. Which of the following is the PRIMARY function of the CDM?

Accepted Answer

To list all billable items, services, and their corresponding charges for the facility.

Answer

To track the productivity of clinical staff based on services rendered.

Answer

To serve as the primary medical record for all patient encounters.

Answer

To negotiate reimbursement rates with commercial insurance payers.

Question 2

A patient receives a routine blood draw (phlebotomy) and a complex series of lab tests in a hospital outpatient setting. Which two code sets would MOST likely be used to capture the services and diagnoses for billing?

Accepted Answer

ICD-10-CM and CPT

Answer

HCPCS Level II and ICD-10-PCS

Answer

CPT and ICD-10-PCS

Answer

DSM-5 and HCPCS Level II

Question 3

A revenue cycle representative is reviewing a daily report that compares clinical documentation in the EHR with the charges posted to patient accounts. Several instances are found where a documented procedure was not charged. This process is known as:

Accepted Answer

Charge reconciliation

Answer

Code auditing

Answer

Denial management

Answer

Utilization review

Question 4

Which of the following scenarios would necessitate the use of a HCPCS Level II code instead of a CPT code?

Accepted Answer

Billing for durable medical equipment (DME), such as a wheelchair.

Answer

A physician performing an annual physical exam.

Answer

A surgeon performing an appendectomy.

Answer

A radiologist interpreting a chest X-ray.

Question 5

During a departmental audit, it was discovered that a specific surgical supply was consistently being used during a procedure but was not being documented on the charge sheet. What is the MOST likely negative outcome of this error?

Accepted Answer

Revenue leakage for the healthcare facility.

Answer

Increased patient satisfaction due to lower bills.

Answer

A compliance violation with the Joint Commission.

Answer

Faster claim processing times.

Question 6

The process of translating a physician's documentation of a patient encounter into standardized codes for billing is known as:

Accepted Answer

Medical coding

Answer

Charge entry

Answer

Adjudication

Answer

Pre-authorization