HIF-310 Final Exam

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The SAB=RXNORM normalized name follows the pattern of the ingredient, strength, and dose form where:

"strength" refers to the strength of the active ingredient in the drug

The characteristics of NDCs can be described as:

10 digits, three-segment number

The UMLS consists of

3 parts: the Metathesaurus, Specialist Lexicon, Semantic Network

ASC X12 Version 05010 (5010) requires which NDC reporting format?

5-4-2

Along with the base LOINC standard, Regenstrief distributes a set of accessory files for LOINC implementers based on the premise that:

A few codes account for the vast majority of typical use for a given purpose

A Metathesaurus is:

A multipurpose vocabulary database that contains metadata about patient care, health services billing, public health statistics, indexing, and cataloging biomedical literature, or basic, clinical, and health services research

Which of the following is the most accurate observation concerning map development between disparate systems?

A perfect mapping process does not exist due to system variability

This phrase used in mapping described as "one to many" indicates:

A single concept within the source is mapped to multiple concepts in the target

The NANDA Classification is a:

A value set of for nursing diagnoses

An intentional process applied to or performed by a client is the definition of which ICNP axis?

Action

DSM-5 includes revisions to the following:

All of the above

In the 2013 agreement between Regenstrief Institute and the IHTSDO, the two organizations committed to:

All of the above

In which of the following practice settings is the Code recognized as the standard dental procedural code reference for dentists?

All of the above

Maps have been created between SNOMED CT and which of the following?

All of the above

The ICF can be used to:

All of the above

The Perioperative Nursing Data Set benefits surgical endeavors by:

All of the above

Which of the following is a component of a dental procedure code?

All of the above

Which section of the Code would be used to look up a dental term?

Alphabetic Index to the Code

HCPCS level II modifiers are:

Alphanumeric or two letters

The Nursing Information and Data Set Evaluation Center is affiliated with the:

American Nurses Association (ANA)

Mapping projects should follow a set of principles for development. Which of the following examples are useful?

Apply the URU principle to ensure the map is understandable, reproducible, and useful

Which of the following statements is true of RxNorm?

As a controlled vocabulary, RxNorm limits itself to the types of medications taken by patients and prescribed by practitioners.

What type of model views functioning and disability as an interaction among one's biological, psychological, and social factors?

Biopsychosocial Model

According to the MMA's payment provision, when a new drug approved by the FDA is covered under the hospital OPPS, for which a product-specific HCPCS code is not available, what must be reported?

C9399 along with the NDC, quantity of the drug administered and date the drug was provided

Which vocabulary is not found in the Common MU Data Set?

CVX

The Clinical Care Classification system:

Can be used in a variety of care delivery locations

Which of the following is SNOMED CT not ideally suited for:

Capture services in coded form to submit on a claim for reimbursement

Which of the following services is not included in an anesthesia code?

Central venous catheter placement

"A concise statement of the symptom, problem, condition, diagnosis, or other factor that is the reason for the encounter" defines the:

Chief complaint

Which of the following is a content standard that was developed by Health Level Seven International (HL7) to be an interchange standard to support the electronic documentation of patient encounters and services?

Clinical Document Architecture

In the context of the work products provided by standards developers, identify an example of a healthcare IT standard.

Clinical Document Architecture (CDA)

LOINC's primary role is to provide universal identifiers for:

Clinical tests, measurements, and other observations

The Unified Medical Language System (UMLS) cross references:

Clinical vocabularies and classification systems

Which of the following is a reason why the Global Assessment of Functioning (GAF) was eliminated from DSM-5?

Clinicians often found it confusing and unreliable.

SNOMED was originally developed by what group?

College of American Pathologists

Which of the following defines terminology messaging procedures regarding terminology translation and display?

Common Terminology Services (CTS)

What is one of the four essential characteristics of ICD-10-PCS?

Completeness

Which of the following is defined as unique units of knowledge created by a unique combination of characteristics?

Concepts

Select the correct answer about types of maps used in healthcare:

Context dependent maps are supported from SNOMED CT to the ICD-10 (unmodified version) from the World Health Organization and the IHTSDO standards bodies

Which group does not have representatives on the Code Maintenance Committee?

Council on Dental Benefits Programs

Which of the following is not an | is a | relationship in SNOMED CT?

Cystitis | is a | lung disease

Which of the following is a dental procedure code?

D2000

Which of the following choices comprise the first step when considering data mapping?

Define the business case for the project to confirm potential value in the expected results

The use of the term "equivalence" in discussing Mapping protocol provides the:

Degree of proximity in the mapping relationship

Which component of ICPC is used when there is no underlying pathology for the problem being managed?

Diagnostic and preventive procedures

Which of the following services is not included in CPT surgical package guidelines?

E/M service for postoperative care related to a complication

The LOINC development process can be characterized as?

Empirical, nimble, open

The CDT manual is updated and published:

Every year

Select the correct choice below to fill in the blank: The _______________ mechanism is a structure that enables authorized organizations to add Concepts or Descriptions to the core content of the SNOMED CT International Release.

Extension

Which of the following is not a level of medical decision making?

Extensive complexity

True or false? 4012F, Warfarin therapy prescribed, is a HCPCS level II code.

False

True or false? A descriptor is a concise written definition of a dental procedure code.

False

True or false? A licensing agreement was signed between Health and Human Services (HHS) and International Health Terminology Standards Development Organization (IHTSDO) that allows US users access to SNOMED CT at a nominal fee through the national library of medicine (NLM).

False

True or false? A technical advisory panel concluded that a clinical modification of ICD-10 was not advantageous in the United States.

False

True or false? As a licensee of the Code, the ADA allows the modification of code descriptors to match an individual dentist's terms.

False

True or false? Both ICD-9-CM and ICD-10-CM codes must be noted when recording a diagnosis.

False

True or false? Data mapping in health care is limited to linking classifications with existing terminology standards

False

True or false? Determinations of coverage and payment for HCPCS codes are part of the update process.

False

True or false? Diagnosis alone can predict service needed, length of hospitalization, level of care, and functional outcomes.

False

True or false? Functioning properties are one of the attributes expected on initial publication.

False

True or false? HCPCS J codes are more specific than NDC codes in that they identify the drug and dosage.

False

True or false? ICD-10 codes are entirely numeric.

False

True or false? ICD-10 is not copyrighted.

False

True or false? ICD-O-3 uses the ICD-10 uncertain whether malignant of benign category for topography.

False

True or false? ICPC-2 is a reference classification.

False

True or false? If an individual has a health condition, it should be assumed that s/he will have difficulties with functioning.

False

True or false? LOINC adoption in the United States is limited primarily to the private sector.

False

True or false? MetamorphoSys is a very large, multipurpose, and multilingual vocabulary database found in UMLS.

False

True or false? Modifiers are used only for convenience.

False

True or false? NDCs are maintained by CMS.

False

True or false? Once terminologies are coordinated, an essential part to the development of a unified EHR-S, interoperability will result.

False

True or false? Only members of the American Medical Association can request changes to CPT.

False

True or false? SNOMED CT is defined as a comprehensive classification system with code content and expressivity designed to encode and report clinical diseases and diagnoses.

False

True or false? SNOMED CT was developed in 1999 by the International Health Terminology Standards Development Organisation (IHTSDO).

False

True or false? Section II only contains diagnostic criteria and text for mental disorders.

False

True or false? Since CDT is included in HCPCS level II, CMS has the authority to make CDT code modifications.

False

True or false? Standards that are named in regulation are less likely to be adopted and used.

False

True or false? Terminology binding means having a structured relationship between the terminology and classification.

False

True or false? The NCVHS study concluded that only one terminology, SNOMED CT, needed to be named as a PMRI standard.

False

True or false? The RxNorm normalized name consists of the source, strength, and ingredient for a branded drug.

False

True or false? The defined code system for the QDM category Condition/Diagnosis/Problems is ICPC.

False

True or false? The detail of laterality for codes in the Morbidity Linearization will be identified in ICD-11 as it is in ICD-10-CM.

False

True or false? The federal agency that officially adopts the data set establishes the process for revisions and updates.

False

True or false? The foundation component contains residual categories such as "not otherwise specified."

False

True or false? When assigning a code from ICD-10-PCS, the process is similar to ICD-10-CM. The term is always indexed, and all the characters are provided, and then the coding professional checks the code in the Tabular List.

False

The package code is assigned by the:

Firm

Data integrity issues can happen if a map is not ____________. The missing phrase is:

Fit for purpose to meet requirements

The ______ Emergency Care Work Group is updating and revising DEEDS 1.0.

HL7

Which Act through regulation requires HCPCS level II as the standard code set for describing and identifying substances, equipment, supplies, or other items used in healthcare services?

Health Insurance Portability and Accountability Act

Where are ICD-10 codes used in the ICF model?

Health condition

What do the first four digits in the morphology code describe?

Histology

Data elements specified in Outcomes and Assessment Information Set (OASIS) are collected for which type of patient?

Home care patients

ICD-10-PCS was designed as a replacement for:

ICD-9-CM, volume 3

Which of the following is a derived classification?

ICD-O

Formalized terminology in nursing began in which time period?

In the late 1970s when computers began to be used in some healthcare settings

Which of the following is not considered part of counseling for CPT purposes?

Interactive psychotherapy

The NIC System includes which of the following?

Interventions for wellness and illness prevention

Which of the following is true of an RxNorm concept unique identifier (RXCUI)?

It is exclusive to a concept.

What requirement must be met by a drug terminology for it to be used as a standard in the electronic health record (EHR)?

It must be maintained by a primary code-assigning authority.

A patient received a pneumonia vaccine immunization in the office. Which section of HCPCS level II would a code be found for the penicillin?

J codes

Which of the following best illustrates how LOINC and SNOMED CT can work effectively together?

LOINC provides codes that represent "questions" and SNOMED CT provides codes that may represent the "answers."

The core principles of mapping include which of the following:

Maintain

Data mapping includes many types of maps. Which topic is out of place in the choices below?

Mapping classifications directly to the National Library of Medicine's UMLS (Unified Medical Language System)

Glucophage is a branded drug that is commonly used to treat diabetes. The active ingredient in Glucophage is metformin hydrochloride. Each tablet of Glucophage contains 500 milligrams of metformin hydrochloride and is administered orally. What is the normalized name for this branded drug?

Metformin Hydrochloride 500 MG Oral Tablet [Glucophage]

Which data set is used to collect data to classify Medicare residents into Resource Utilization Groups?

Minimum Data Set

Which of the following is not a section in CPT?

Miscellaneous

Which of the following is not a diagnostic class in DSM-5?

Mood Disorders

Which of the following is an architectural innovation of ICD-11?

Multi-layered manifestation

Which of the following statements is false?

NANDA and NOC are used for the same purpose.

Which of the following statements is false?

NIC is used for reimbursement of nursing care for Medicare patients.

Who is the central coordinating body for clinical terminology standards in the US?

NLM

Which metadata repository provides content for cancer care?

National Cancer Institute Thesaurus

Which chapter does not use seventh characters in ICD-10-CM?

Neoplasms

Which HIPAA medical code set is the ABC codes intended to replace?

None of the above

Which of the below is true about the ICF?

None of the above

Which of the following statements is consistent with the vision of NANDA International?

Nursing diagnosis is seen as an essential component of any professional nursing-client interaction.

Which element of the problem-oriented medical record SOAP is not classified in ICPC?

O: Objective observations

__________is the performance measurement and improvement initiative integrated into The Joint Commission's accreditation process.

ORYX

Gender is an example from which SNOMED CT hierarchy?

Observable entity

Identify the true statement with regard to how RxNorm names are assigned to drugs in the National Library of Medicine (NLM).

Once the NLM recognizes that the drug names received from different data sources are for a single product, it assigns one RxN1 name to the product.

Identify a liquid RxNorm dose form that is intended for use in or on the ear.

Otic cream

Which two systems have many of the same uses?

PNDS and the Omaha System

What ICF term is used to describe a problem an individual may experience in involvement in a life situation?

Participation Restriction

A search in the NDC directory resulted in NDC code 17856-0759-5. What does the 0759 represent?

Product code

Where can public health specific terminology created by the CDC be found?

Public Health Information Network Vocabulary Access and Distribution System (PHIN VADS)

Which of the following are out of scope for making names in RxN1?

Radiopharmaceuticals

The developer of LOINC is:

Regenstrief Institute, Inc.

A program for mapping local files to LOINC is

Regenstrief LOINC Mapping Assistant (RELMA®)

Which of the following factors have significantly contributed to LOINC adoption outside of the United States?

Regenstrief has developed processes and tools specifically for helping volunteers translate LOINC into foreign languages

In the UMLS Metathesaurus concepts are linked by:

Relationships

Which of the following is not a part of the core content of SNOMED CT?

Relationships table

HCPCS was developed to:

Report physician and nonphysician services

Which application is an example of where aggregate data is necessary?

Reporting medical diagnoses, procedures, and services on healthcare claims in order to receive third-party payment

Health IT interoperability is dependent on which element?

Rules of engagement or governance

Which of the following is standard for drugs under the meaningful use program?

RxNorm

___________ rules specify incorrect or non-allowable post-coordinated expressions.

Sanctioning

Which part of the NDC identifies strength, dosage form, and formulation?

Second part (Product code)

Which of the following statements is true of the standards development process?

Standards often go through multiple drafts that sometimes take two or more years to resolve.

An example of work involving terminology binding and the information model is the HL7 _________.

TermInfo project

What is used to house terminologies and classifications for use within EHRs?

Terminology server

Which of the following bodies can issue official CPT coding guidelines?

The American Medical Association

PHIN VADS is affiliated with:

The Centers for Disease Control (CDC)

The package and product codes are assigned by:

The drug product firm

The normalized name for a drug that is commonly prescribed for treating bacterial infections is Amoxicillin 250 milligram tablet. What standard does "Amoxicillin" represent?

The ingredient

Critical care services must satisfy three criteria. They are:

The nature of the problem, the nature of the treatment, and time

Which of the following statements about category II codes is false?

They are mandatory

Under the 2013 agreement between Regenstrief Institute and the IHTSDO, how will LOINC terms for concepts not already present in SNOMED CT be represented?

They will be associated with post-coordinated expressions

Which of the following is true of the Digital Imaging and Communications in Medicine (DICOM) standard?

This standard can ease the development and expansion of picture archiving and communication systems.

Body Structure codes in the ICF have how many qualifiers?

Three

What is the purpose behind development of the NOC system?

To evaluate the outcomes of nursing interventions

Which symbol indicates a revision to a code?

Triangle

True or false. ICD-10-CM is a system HIPAA requirement for administrative applications.

True

True or false? A "Classification of Materials" is found in found in Section 1: Code on Dental Procedures and Nomenclature.

True

True or false? A device in ICD-10-PCS applies only to devices that remain after the procedure is completed.

True

True or false? DSM-5's suggested disability measure, the World Health Organization Disability Assessment Schedule 2.0, can be freely downloaded online. Select one:

True

True or false? Data element attributes are a part of a data dictionary.

True

True or false? Each rubric of a linearization has one and only one parent.

True

True or false? Embedded within MedDRA are many other coding and reporting systems.

True

True or false? Federal laws governing Medicare require CMS to contract with entities to process and pay claims containing diagnosis and HCPCS codes.

True

True or false? For each drug product named in RxNorm, there will be relationships to synonyms and ingredients, as well as National Drug Code (NDC), manufacturer, and pill size attribute.

True

True or false? HCPCS codes are required for physician reimbursement only.

True

True or false? HCPCS level II describes products and medical supplies.

True

True or false? ICD-10-CM provides many combination codes for etiology/manifestation combinations.

True

True or false? ICD-11's content model will include diagnostic criteria, which currently do not exist in ICD-10.

True

True or false? If a category III code exists to describe a procedure, an unlisted category I code may not be reported.

True

True or false? If a disorder can only be diagnosed if the symptoms do not last more than 6 months, and a persistently symptomatic patient has only experienced the symptoms for 5 months, a provisional diagnosis can be given until the 6-month point has passed.

True

True or false? If a separate procedure is an integral part of another procedure, it is not reported separately.

True

True or false? Mapping clinical assessment data to standards/regular reporting is possible.

True

True or false? Market demand is one of the key determiners of the time it takes to produce a standard and put it to work.

True

True or false? Medication-Induced Movement Disorders are located in Section II of DSM-5.

True

True or false? NDCs have been adopted as a HIPAA code set.

True

True or false? National Drug Codes serve as universal product identifiers for prescription drugs.

True

True or false? Not all data types or elements in the common set of meaningful use data set have a vocabulary standard.

True

True or false? Other Conditions That May Be a Focus of Clinical Attention have been assigned valid codes for both ICD-9-CM and ICD-10-CM.

True

True or false? Parentheses ( ) enclose a code range for a block in ICD-10.

True

True or false? SNOMED CT is capable of expressing all components of the neonatal Apgar score in code form.

True

True or false? Terminologies are very granular and thus able to codify the clinical content of a health record.

True

True or false? The NDC Directory contains drug product and firm information.

True

True or false? The diagnoses of malignant neoplasm of the breast, in situ neoplasm of breast, and benign neoplasm of breast would all have the same topography code in ICD-O-3.

True

True or false? The overall aim of the ICF is to provide a unified and standard language and framework for the description of health and health-related states.

True

True or false? The term "Contextual Factors" includes Environmental Factors and Personal Factors.

True

True or false? Third-party payers may submit CDT code change requests.

True

Which LOINC naming axis is optional?

Type of Method

Which of the following is NOT a LOINC naming axis?

Type of test

Which of the following choices best describes a successful outcome from a data map?

Understandable, reproducible, useful

Which of the following terminologies can be used to identify cross walks between terminologies?

Unified Medical Language System (UMLS)

When diagnosis-related groups (DRGs) were implemented in 1983, which data set definitions were incorporated into its payment system?

Uniform Hospital Discharge Data Set

When a request to add a HCPCS code is sent to the Workgroup, one possible outcome is to?

Use an existing code

Which HCPCS level II section(s) contains temporary codes?

a and b K codes b. Q codes

The Food and Drug Administration requires the use of MedDRA for the coding of medical terms when electronically submitting ________.

a and b a. adverse event reports Incorrect b. cause of death

FDA's therapeutic area standards initiative involves defining a master set of data elements with their attributes where the attributes will include ____________.

a, b, and c

A core data element category for the Transitions of Care initiative is the __________.

active problem list

The work groups that can be found in the Technical and Support Services steering division of Health Level Seven International (HL7):

are responsible for developing tools used to create the standards from the various design inputs provided by the work groups

The "X chapter" contains the _______________.

axes for post-coordination content

A client has 20% impairment in Memory Functions. The code for Memory Functions is b144. Which of the below represents the correct score?

b114.1

The data exchange standards that describe messaging protocols, workflows, and the algorithms to be executed by communicating systems are known as:

behavioral standards.

The chapter structure of the DSM-5 Classification:

better matches the structure of the mental health chapter of the ICD-11

Injuries in ICD-10-CM are grouped by

body part

What is the root operation for bypass, one coronary artery to left internal mammary artery in ICD-10-PCS?

bypass

Which of the following are core components of SNOMED CT?

c, d, and e c. Concepts d. Descriptions e. Relationships

The ICD-11 core development group was comprised of __________.

clinical disease experts

A client had moderate difficulty when swimming alone at the local health club. The ICF code for swimming is d5445. Which of the below reflects the appropriate scored code?

d5445._ _ _ 2

Standard developers are primarily concerned with:

drafting new standards or updating existing ones.

When more than one reason for the encounter is described by the patient, __________.

each reason is coded

Section I of DSM-5:

explains the history, purpose, and use of DSM-5

The ________ forms the basis for cross-linearization mapping.

foundation component

HEDIS collects standardized data from _______.

health records in clinics and hospitals

The ______ is the language-specific term typically shorter the fully specified name.

preferred name

A derived classification is based on a ________ classification.

reference

When the mutual understanding of the meaning of data exchanged between information systems is achieved using standards, it is known as _____.

semantic interoperability

The primary purpose of data exchange standards is to:

send and receive clinical and administrative data in an usable manner across information systems.

Which of the following is a terminology implementation challenge?

standards selection

The primary purpose of RxNorm is to:

support semantic interoperability between multiple drug terminologies

The first phase of the standards development process is most likely to involve:

the formation of standards.

Derivative linearizations will be _______.

versioned

An unspecified diagnosis should be used:

when insufficient information is available to make a diagnosis beyond diagnostic class


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