CRCR - Certified Revenue Cycle Representative Program Charge Capture and Coding Flashcards
6 cards from real CRCR practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CRCR - Certified Revenue Cycle Representative Program Charge Capture and Coding flashcards as text
What is the consequence of undercoding a procedure in healthcare billing?
Answer: Loss of revenue that the provider is legitimately entitled to
Undercoding assigns a less specific or lower-level code than warranted, resulting in lower payment than the provider deserves.
Which document serves as the primary source for charge capture in a hospital setting?
Answer: The medical record and clinical documentation
Charges must be supported by clinical documentation in the medical record, which is the authoritative source for what services were rendered.
What does CDM stand for in revenue cycle management?
Answer: Charge Description Master
The Charge Description Master is the comprehensive list of services, supplies, and procedures with their associated charges and codes.
What does the Present on Admission indicator report on inpatient claims?
Answer: Whether a diagnosis existed at the time of inpatient admission or developed during the hospital stay
The POA indicator flags whether a diagnosis existed at the time of inpatient admission, affecting reimbursement and quality metrics.
Which coding system is used primarily for outpatient hospital billing to describe procedures and services?
Answer: HCPCS and CPT codes
HCPCS including CPT codes is used for outpatient billing to describe procedures, services, and supplies.
A hospital charge capture audit reveals that nurses are not documenting IV solution administration. What is the most appropriate corrective action?
Answer: Implement education and a documentation compliance process for nursing staff
Correcting charge capture gaps requires education and process improvement to ensure consistent documentation going forward.