CRCR Charge Capture and Coding 4

Question 1

Which HCPCS Level II code category is used to report drugs administered in a physician office or outpatient setting?

Accepted Answer

J codes (Drugs Administered Other Than Oral Method)

Answer

HCPCS Level II J codes are used to identify injectable drugs and other medications that cannot be self-administered, often in outpatient or office settings.

Question 2

What is the primary purpose of the 'present on admission' (POA) indicator?

Accepted Answer

To distinguish conditions that existed at admission from hospital-acquired conditions

Answer

The POA indicator tells payers whether a diagnosis was present when the patient was admitted, which affects reimbursement for hospital-acquired conditions.

Question 3

A coder reviews a record where the physician documents 'probable pneumonia.' For an inpatient claim, how should this be coded?

Accepted Answer

Code pneumonia as if confirmed per inpatient guidelines

Answer

Inpatient coding guidelines allow coding of conditions documented as 'probable,' 'suspected,' or 'likely' as if confirmed, unlike outpatient guidelines.

Question 4

Which section of the ICD-10-PCS code set would be used to code a total knee replacement performed during an inpatient stay?

Accepted Answer

Medical and Surgical (Section 0)

Answer

Section 0 (Medical and Surgical) of ICD-10-PCS covers all surgical and invasive procedures including orthopedic replacements performed on inpatients.

Question 5

A charge capture audit reveals that charges for a specific lab panel are being missed routinely. The best corrective action is to:

Accepted Answer

Update the charge capture workflow and CDM to ensure the panel triggers automatically

Answer

The root cause of missed charges is typically a process or system issue; updating workflows and CDM triggers prevents future revenue leakage.

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR Charge Capture and Coding 4