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

Undercoding assigns a less specific or lower-level code than warranted, resulting in lower payment than the provider deserves.

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

Charges must be supported by clinical documentation in the medical record, which is the authoritative source for what services were rendered.

Question 3

What does CDM stand for in revenue cycle management?

Accepted Answer

Charge Description Master

Answer

The Charge Description Master is the comprehensive list of services, supplies, and procedures with their associated charges and codes.

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 POA indicator flags whether a diagnosis existed at the time of inpatient admission, affecting reimbursement and quality metrics.

Question 5

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

Accepted Answer

HCPCS and CPT codes

Answer

HCPCS including CPT codes is used for outpatient billing to describe procedures, services, and supplies.

CRCR - Certified Revenue Cycle Representative Program Practice Test