CRC Compliance & Regulatory Requirements

Question 1

Which law is designed to protect patient health information (PHI)?

Accepted Answer

HIPAA

Answer

FMLA

Answer

OSHA

Answer

FERPA

Question 2

What is the purpose of a compliance program in medical coding?

Accepted Answer

Promote accurate coding and prevent fraud

Answer

Reduce patient volume

Answer

Avoid chart reviews

Answer

Increase revenue automatically

Question 3

What is considered an example of upcoding?

Accepted Answer

Reporting a more severe diagnosis than supported

Answer

Reporting accurate conditions

Answer

Using unspecified codes

Answer

Omitting a resolved condition

Question 4

How often should coding compliance audits be performed?

Accepted Answer

Annually or regularly

Answer

Once every five years

Answer

Only after violations

Answer

Never, if coders are trained

Question 5

What federal agency enforces healthcare fraud and abuse laws?

Accepted Answer

OIG

Answer

NIH

Answer

IRS

Answer

DEA

Question 6

Which of the following is a best practice for regulatory compliance in coding?

Accepted Answer

Ensure regular audits and documentation

Answer

Rely solely on software tools

Answer

Code for maximum reimbursement

Answer

Use past codes without review