Because the Diagnosis and Procedure Codes Reported Affect the DRG

question 21

Multiple Choice

Because the diagnosis and procedure codes reported affect the DRG selected (and resultant payment) , some hospitals engage in a practice called __________, which is the assignment of an ICD-10-CM diagnosis code that does not match patient record documentation, for the purpose of illegally increasing reimbursement.

• A) downcoding
• B) jamming
• C) unbundling
• D) upcoding

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Definitions:

Kubler-Ross's Stages

A model detailing five stages of grief individuals often experience after loss: denial, anger, bargaining, depression, and acceptance.

Universality

The quality of being universally applicable or prevalent across all cultures, situations, or communities.

Colin Turnbull

An anthropologist known for his studies of the Pygmies in the Congo and his contributions to the field of social anthropology through his ethnographic work.

Awareness Context

What each interacting person knows of the patient’s defined status and his or her recognition of the others’ awareness of a personal definition.