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:

Self-actualization

The realization or fulfillment of one's talents and potentials, considered as the ultimate objective of personal development.

Self-esteem

An individual's subjective evaluation of their own worth or personal value.

Spotlight Effect

The inclination to believe that others notice our behavior and looks more than they actually do.

Reciprocal Determinism

A theory in psychology that suggests that a person's behavior both influences and is influenced by personal factors and the social environment.