CRCR CRCR - Certified Revenue Cycle Representative Program Charge Capture and Coding 2

Question 1

What is the consequence of undercoding a procedure in healthcare billing?

Accepted Answer

Loss of revenue that the provider is legitimately entitled to

Answer

Increased reimbursement from the payer

Answer

Triggering a Medicare fraud investigation automatically

Answer

Reduced claim processing time

Question 2

Which document serves as the primary source for charge capture in a hospital setting?

Accepted Answer

The medical record and clinical documentation

Answer

The patient's insurance card

Answer

The payer's fee schedule

Answer

The hospital's chargemaster only

Question 3

What does CDM stand for in revenue cycle management?

Accepted Answer

Charge Description Master

Answer

Claims Data Management

Answer

Clinical Documentation Manual

Answer

Coded Diagnosis Module

Question 4

What does the Present on Admission indicator report on inpatient claims?

Accepted Answer

Whether a diagnosis existed at the time of inpatient admission or developed during the hospital stay

Answer

The patient's principal diagnosis at the time of coding

Answer

The attending physician's specialty

Answer

The patient's discharge status

Question 5

Which coding system is used primarily for outpatient hospital billing to describe procedures and services?

Accepted Answer

HCPCS and CPT codes

Answer

ICD-10-CM

Answer

ICD-10-PCS

Answer

DRG codes

Question 6

A hospital charge capture audit reveals that nurses are not documenting IV solution administration. What is the most appropriate corrective action?

Accepted Answer

Implement education and a documentation compliance process for nursing staff

Answer

Remove IV solutions from the chargemaster

Answer

Bill for IV solutions without documentation retroactively

Answer

Reduce the charge for IV solutions by 50%