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Rationale 4: •Electronic health records—where value-driven health care supports the use of information
technology to give providers the ability to deliver high quality, efficient, well coordinated care (Goals For Value-
Based Purchasing, 2010, p. 4).
Rationale 5: •Electronic health records—where value-driven health care supports the use of information
technology to give providers the ability to deliver high quality, efficient, well coordinated care (Goals For Value-
Based Purchasing, 2010, p. 4).
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Communication and Documentation
Learning Outcome:
Question 13
Type: MCSA
On October 1, 2013, the federal government will implement the mandatory transition to the International
Classification of Diseases, Tenth Revision (ICD-10). Of the following responses, which is the most reasonable
rationale for the upgrade?
1. The ICD-10 is an easier method of coding to use in a complicated health care delivery system.
2. The ICD-10 transition is to better manage the quality of health care data through more precise and accurate
diagnostic coding.
3. The ICD-10 initiative is to ensure improved patient outcomes.
4. The ICD-10 has been designed to improve the collection of data at the point of care.
Question 14
Type: MCSA
One of the biggest pitfalls and concerns to health care providers to the transition to the ICD-10 by 2013 is which
of the following?
1. Training staff to use the new system efficiently
2. Having enough qualified personnel available to troubleshoot impending issues
3. The need to overcome resistance to change in the health care setting
4. The cost to convert the current systems to accommodate the changes
Question 15
Type: MCSA
Despite the negative responses by health care providers toward the transition from ICD-9 to ICD-10, which of the
following statements is a clear benefit of the transition?
1. Over 100 countries have already adopted the ICD-10 coding system.
2. Coding solutions will be clearly understood by all health professionals.
3. The impact on small physician's practices will be negligible.
4. More nurses will be hired to maintain the systems.
Question 16
Type: MCSA
Hebda, Handbook of Informatics, 5/e Test Bank
Copyright 2012 by Pearson Education, Inc.
Which type of billing codes is used by Medicare to determine the level of severity and per diem rate?
1. POA
2. MS-DRG
3. ICD
4. PPAC
Question 17
Type: MCMA
The importance of billing codes and reimbursement for services cannot be overstated. Which of the following
responses are true regarding accurate code input and claims processing?
Standard Text: Select all that apply.
1. CPT codes were grouped into services by the first digit followed by four more digits that further described the
procedure.
Hebda, Handbook of Informatics, 5/e Test Bank
Copyright 2012 by Pearson Education, Inc.
2. The number 9 is reserved for visits related to evaluation and management procedures.
3. The CPT code 99211 is an office visit and used for injections.
4. Two digit modifiers are used to further distinguish services and procedures altering the billing process.
5. Inaccurate code input will delay claims processing.
Hebda, Handbook of Informatics, 5/e Test Bank
Copyright 2012 by Pearson Education, Inc.
Question 18
Type: FIB
The __________________________ was developed by Medicare in an effort to control quality and cost and
minimize preventable complications.
Standard Text:
Correct Answer: Do Not Pay list
Rationale : In an effort to control the quality and cost of health care, Medicare developed a "Do Not Pay" list for
preventable complications.
Global Rationale:
Cognitive Level: Understanding
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Caring
Learning Outcome:
Question 19
Type: MCSA
Which of the following statements is true about the do-not-pay list?
1. If a patient develops a complication, Medicare will reimburse for all services.
2. If a patient develops complications, Medicaid will reimburse for all services.
3. If a patient has certain complications during the hospital stay, Medicare will not reimburse the hospital at the
higher rate for the treatment.
4. If a patient develops a preventable complication, Medicare will demand the immediate transfer of the patient to
a different health care setting.
Question 20
Type: MCSA
What is the rationale the AMA is using to oppose the do-not-pay list?
1. Physicians assert each patient's circumstances are unique and complications cannot always be prevented or
explained.
2. The physicians assert this reimbursement ruling is unjust.
3. The physicians assert the do-not-pay list is punitive to health care providers.
4. The physicians assert do-not-pay list minimizes complications.
Question 21
Type: MCSA
Which of the following statements is true about the projected results of the increase in federal and state mandated
health care cost reform legislation?
1. The increase in governmental regulations provides for a higher quality of care.
2. Governmental oversight is something that has been lacking in health care over the past several years.
3. The burden of proof is placed on the health care community.
4. The increase in governmental oversight allows for improved outcomes with decreased FTEs.
