Healthcare Documentation Fundamentals And Practice: Chapter 2

Front 1

The agency or organization that administers Medicare and Medicaid reimbursements is

Back 1

CMS

Front 2

Codes assigned to diagnoses and surgical procedures for purposes of reimbursement and other uses are

Back 2

ICD codes

Front 3

Federal legislation detailing the requirements for privacy and confidentiality of patient information is named

Back 3

HIPAA

Front 4

Clinicians who may dictate healthcare documentation reports include all of the following EXCEPT

Back 4

RHIA

Front 5

All or the following are codes that determine reimbursement EXCEPT

Back 5

ADT

Front 6

The individual responsible for knowing which documents were part of the legal healthcare record and which were not is the

Back 6

chart assembler

Front 7

The role of The Joint Commission is

Back 7

to accredit hospitals and other healthcare insitutions

Front 8

Which of the following is often handwritten in the healthcare record?

Back 8

Daily progress notes by nurses and physicians

Front 9

Reports that are usually machine-generated include

Back 9

clinical laboratory reports

Front 10

The "basic four" reports in hospitals and larger healthcare facilities include all of the following EXCEPT

Back 10

emergency department reports

Front 11

Reports that are more commonly generated in physicians' offices rather than hospitals include

Back 11

consultation reports

Front 12

The laboratory study that includes hemoglobin and hematocrit is the

Back 12

complete blood count

Front 13

Cholesterol and triglycerides are included on which laboratory panel?

Back 13

Lipid profile

Front 14

Red and white blood cell counts are included in which laboratory study?

Back 14

Complete blood count or CBC

Front 15

ALT, AST, and LDH are used to evaluate

Back 15

liver function

Front 16

An electrolyte panel includes which of these studies?

Back 16

Sodium, potassium, calcium, and chloride

Front 17

The microbiology department performs which of the following tests?

Back 17

Culture and sensitivity

Front 18

______ are covered with a special coating that resists stomach acid but dissolves in the alkaline environment of the small intestine to avoid irritating the stomach.

Back 18

Enteric-coating tablets

Front 19

______ contain fine, undissolved particles of drug suspended in a water base.

Back 19

Suspensions

Front 20

Parenteral administration includes all of the following routes of administration EXCEPT

Back 20

nasogastric