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NEW QUESTION # 38
What is the goal of an MSSP program?
Answer: D
Explanation:
The Medicare Shared Savings Program (MSSP) is designed to move reimbursement away from pure volume-based payment and toward value by rewarding organizations that reduce the total cost of care for an assigned Medicare population while meeting defined quality performance requirements. In MSSP, eligible provider groups participate as Accountable Care Organizations (ACOs) and are compared against a financial benchmark. If the ACO's actual spending comes in below the benchmark and quality standards are achieved, the ACO can earn a portion of the savings-hence "shared savings." Outpatient CDI supports MSSP success by ensuring documentation accurately reflects patients' true disease burden (supporting appropriate risk adjustment for benchmarking), and that conditions addressed during visits are clearly documented as evaluated/managed to support reliable coding and quality measurement. While improving transitions of care may be a strategy that helps achieve savings and quality goals, it is not the core purpose of the program itself. Likewise, MSSP is not intended to increase fee schedule payments or simply optimize risk scores; the primary aim is participating in value-based care and sharing in savings when performance supports it.
NEW QUESTION # 39
A patient presents to the office complaining of lower abdominal pain and burning urination. Urinalysis indicates WBC >10, positive nitrites, and leuk esterase. Documentation identifies pain, urinary frequency, and fever likely UTI. Cultures are pending for E-Coli. The patient is started on antipyretics and Levaquin. Which of the following conditions can be reported?
Answer: B
Explanation:
In the outpatient setting, uncertain diagnoses described with terms such as "likely," "probable," "suspected," or "rule out" generally are not reported as established conditions for coding purposes. Instead, the encounter is coded to the confirmed signs and symptoms documented and evaluated at that visit. Here, the provider's assessment is "likely UTI," with urine culture results still pending, so a definitive UTI diagnosis is not yet confirmed within the scenario. Likewise, the organism (E. coli) cannot be coded because it is only suspected and not confirmed until culture results are finalized. Outpatient CDI emphasizes aligning reportable diagnoses to what is clearly supported as present and addressed during the visit. The note explicitly identifies pain, urinary frequency, and fever-symptoms that drove evaluation and treatment (antipyretics and antibiotic initiation). Between the answer choices, "abdominal pain, fever, and urinary frequency" best represents the reportable conditions based on documented, evaluated symptoms without coding an uncertain infection diagnosis or an unconfirmed causative organism.
NEW QUESTION # 40
The majority of E/M services are based on which of the following criteria?
Answer: D
Explanation:
In outpatient CDI and coding education, selecting the correct E/M code starts with identifying the encounter category (e.g., office/outpatient vs inpatient/observation vs ED) and whether the patient is new or established, because these define the applicable CPT code range. Next, the level of service is selected within that range based on the documentation supporting the required elements for that code family. For most E/M services, "site of service" (place/setting) and "new vs established" are foundational code-selection drivers, while "level" is determined by the record's support for the applicable leveling methodology (commonly medical decision making and, when allowed/appropriate, time). Time can be a valid leveling method for many office/outpatient E/M visits, but it is not universally the basis for the majority of E/M services across all categories; it is an alternative pathway when documentation supports it. Physician specialty and patient age do not define the majority of E/M code selection. Therefore, the best overall statement is new/established status + site of service + level of service.
NEW QUESTION # 41
Which of the following Medicare patients demonstrates the highest level of risk based on the above chart?
Answer: B
Explanation:
The Relative Factors table shown is a demographic/eligibility-driven component of risk scoring for female beneficiaries, separating patients by setting/status (community vs institutional) and age band. "Institutional" beneficiaries carry higher expected cost because they typically require more resources and support than community patients. In the chart, the institutional relative factor for females age 70-74 is higher than the community factors shown for similar ages and higher than the 90-94 institutional factor displayed. Among the answer choices, option C is the only patient who matches an institutional setting (skilled nursing facility) in the 70-74 age band (72 years). Option D is also institutional, but the table's 90-94 institutional value is lower than the 70-74 institutional value in this specific chart. Options A and B are community patients, whose relative factors are lower than the institutional values shown. While the listed diagnoses are clinically important and may affect HCC-based risk, the question asks "based on the above chart," so the highest risk is determined by the chart's demographic/setting factor-making the 72-year-old institutional patient the highest.
NEW QUESTION # 42
If a patient is being seen for follow-up and the documentation indicates that the patient was admitted to the hospital 28 days ago with an acute cerebral infarction with remaining right-sided weakness, which of the following diagnoses would be MOST appropriate?
Answer: B
Explanation:
In the outpatient follow-up setting, when the acute stroke event has occurred in the recent past and the patient is now being evaluated for residual deficits, documentation and coding should focus on the sequelae (late effects) rather than re-coding the acute infarction itself-unless the provider clearly states the stroke is still in the acute phase and being actively treated as such. ACDIS outpatient CDI principles stress selecting the diagnosis that best reflects the reason for today's encounter and the condition being assessed/managed. Here, the ongoing clinical issue driving follow-up care is the persistent neurologic deficit (right-sided weakness/hemiparesis) after the cerebral infarction. Option C is the most specific and clinically accurate because it captures (1) the relationship to the prior cerebral infarction ("following cerebral infarction") and (2) laterality and dominance ("right dominant side"), which improves code specificity and reflects functional impact. Option A incorrectly keeps the focus on an unspecified cerebral infarction rather than the residual deficit, and option D is too nonspecific compared with a clearly described hemiparesis.
NEW QUESTION # 43
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