Part 1 — (CH 4 – Data Quality and Management)

Part 1 — (CH 4 – Data Quality and Management)

 

You are the director of HIM at Community Hospital, a small hospital that has just merged with another hospital in your area. The facilities are roughly the same size. Approximately half of the physicians at your facility also have privileges at the other facility.

 

With some exceptions, the two facilities have similar departments and services. Both facilities have some EHR capabilities and are able to interface because they use the same software vendor. Full computerization will not take place for at least 5 years.

 

The administration of the two facilities would like to standardize the data collection with the goal of reducing the cost of forms and facilitating communication between the two facilities. As the senior director, you have been asked to coordinate this effort.

 

Demonstrate your learning by providing concise explanations to the following questions. Practical examples are always helpful for illustrating your understanding and insights.

 

What issues do you think should be addressed first? Who will you ask to assist in the project?

What impact does this standardization project have on the HIM department?

Part 2 — (CH 5 – Coded Data)

 

Demonstrate your learning by providing concise explanations to the following questions. Practical examples are always helpful for illustrating your understanding and insights.

 

Describe reasons why is it important to have knowledge of ICD-9-CM.

What main advantage does ICD-10-CM have over ICD-9-CM?

Describe how the structure of ICD-10-PCS enables the addition of new codes.

Describe the process of building ICD-10-PCS codes, including what each of the characters – in order — composing a code represents.

Part 3 — (CH 6 – Financial Management)

 

Each type of reimbursement has unique characteristics and a different approach to risk.

 

Compare and contrast the four types of reimbursement, identifying the financial risk to the parties involved.

What incentive do physicians have to operate under each of the four methods of reimbursement discussed?