Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Dynamics of Health Care > chapter 9 > Flashcards

chapter 9 Flashcards

(59 cards)

Start Studying
1
Q

What do health information technicians/health information coders/ medical transcriptions do?

A

provide timely and accurate patient documents in an easy to use form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What paperwork is involved in a routine physical exam

A

history
summary of visit
possible lab test results

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do health information technicians do

A

gather paperwork
ensure paperwork is complete
assemble paperwork into well organized medical records

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What did health information technicians evolve from

A

medical record administrators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who was the first medical record administrator. Elaborate

A

Grace Whiting Meyers

was appointed in 1897 at Mass Gen Hospital to organize patient care records from the past 80 years

founded the Association of Record Librarians of North America in 1928

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When and what did the new name of the Association of Record Librarians of North America become

A

American Health Information Management Association (AHIMA)

1991

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happened in 1934 regarding AHIMA, what did this lead to

A

set first official standards for training programs

–> AMA began approving programs in 1942

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Who approved AHIMA programs after the AMA did

A

the Commission on Accreditation for Health Informatics and Information Management Education

(CAHIM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happened in 1953 regarding AHIMA

A

standards were established for programs to train lower level workers (the medical record technician)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What have medical record technicians evolved into? What does this reflect

A

health information technicians

expansion of occupations role from dealing with one record to all records

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do entry level health information technician programs require

A

associates degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What credentials can health information techs get

A

registered health information technicians (RHIT)
= 2 years associates degree program
= 20 CE per 2 years
= 80% of CE in health info. management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 3 categories of health information courses are there

A

general education
professional education
practicum experiences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do the duties of a health information tech depend on

A

the size of teh facility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can health information techs specialize in

A

coding

cancer registry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is health information tech: cancer registry

A

maintain databases for cancer patients
review patient records and assign codes for diagnosis and treatment
follow up with patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the typical tasks of a health. info tech. (6)

A
  • create paper or electronic chart
  • add documents to patient chart
  • make written entries in chart
  • file and retrieve charts
  • release authorized data
  • compute health care statistics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are 3 skills health info techs need

A

organization
detail oriented
communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are 3 factors for the increase in health info techs

A

more medical tests, treatments, procedures
elderly population aging
shift towards electronic records

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does the Ahima maintain for health info techs

A

a fellowship program

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do health information coders to

A

assign numerical codes to identify patient disease, injury, and conditions

codes are used by governmental agencies and insurance companies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When does medical coding date to

A

17th century, London during the bubonic plague

London published the ‘London Bills of Mortality’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Whose work advanced medical coding? Explain

A

William Farr

  • created a uniform system of classification for mortality
  • partially adopted by the second International Statistical Conference in 1855
  • basis of International List of Causes of Death by the International Statistical Institute in 1893
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is mortality

25
what is morbidity
incidence of disease in population (all disease not just fatal disease)
26
What did WHO do in 1948
create a revised list of diseases incorporating both mortality and morbidity International classification of Diseases (ICD)
27
What system of health information coding does the US use? what did they switch to in 2013
a clinical modification (CM) of the ninth revision aka ICD-9-CM switched to ICD-10-CM
28
What is the education of a medical coder
on the job | few schools have associates degree programs that are not accredited
29
How many medical coding certificate programs are there
36
30
How much practical coding experience is needed for a medical coding certification
at least 40 hours
31
How much credentials does the AAPC (American Academy of Professional Coders) award
5 general credentials | 19 specialty credentials
32
What 3 credentials require 2 yrs of medical coding experience by the AAPC
Certified Professional Coder (CPC) Certified Professional Coder-Hopsital (CPC-H) Certified Professional Coder-Payer (CPC-P)
33
What happens if you do not have coding experience and apply for one of the 3 2yr medical coding experience credentials
have apprentice status
34
What credential does the AHIMA offer for medical coders
Certified Coding Associate (CCA) - need 10 CE and 2 annual coding self reviews every 2 years for renewal also has 2 specialty/advanced credentials
35
What "lesser-known' board awards credentials for medical coders
the Board of Medical Specialty Coding and the Professional Association of Healthcare Coding Specialists (PAHCS)
36
What two types of codes do health information coders work with
diagnostic codes | procedure codes
37
What are procedure codes based on
fourth edition of Current Procedural Terminology or CPT-4 by the AMA
38
What does the combination of procedure and diagnostic codes say
tells the insurance company what the patients medical problem was and what type of care the patient received
39
what is the newest trend in health care coding
computer assisted coding or CAC | - scans transcription files and predicts appropraite codes
40
What are the typical tasks of a health information coder (6)
assign diagnostic codes with ICD-9 CM or ICD-10 assign procedure codes with CPT or HCPS monitor patient records for changes and update codes investigate health payment details assist in using coded data for reporting coordinate coding info. with other HC professionals
41
What 3 traits do health information coders need
detail oriented accurate good learners
42
Why is health information coding increasing
rapid growth in medical tests, treatments, and procedures
43
What are the 3 professional organizations for health information coders
AAPC AHIMA Professional Association of Healthcare coding Specialists (PAHCS)
44
When did medical transcription begin
during the beginning of medicine as physicians would record data physicians dictated notes to medical stenographers who would record them in shorthand physicians began dictating into records, secretaries or specialized medical transcriptions would transcribe them
45
What happened in 1960 regarding medical transcriptionists
hospitals staffed medical transcription departments
46
What is a cost control measure for medical transcription
medical transcription is outsourced to medical transcription services in the US or overseas
47
What happened in 1978 regarding medical transcription
Association for Healthcare Documentation Integrity (AHDI) was formed
48
What happened in 1999 for medical transcription
US Department of Labor granted med. transcriptionists their own job classification
49
What is the education of medical transcriptionists
postsecondary training is encouraged but not needed - 2 year associates - or 1 yr certificate
50
Who offers optional approval for medical transcription programs
The Approval Committee for Certificate Programs | - joint committee of AHDI and AHIMA
51
What must medical transcriptionists do for a job
2400 minutes of actual transcription
52
What credentials (2) and designations (1) does the AHDI award
Registered Medical Transcriptionist (RMT) - can apply for Registered Apprenticeship Program Certified Medical Transcriptionist (CMT) - higher than RMT AHDI Fellow (AHDI-F)
53
What do you need for medical trasncriptionist renewal
online course and exam for RMT 30 CE for CMT
54
Describe earning an AHDI fellow
applicants must earn at least 50 points in the five years before applying points must be earned in at least five of 8 categories including 1. membership 2. professional meeting attendance 3. leadership 4. publications and presentations 5. mentor-ship 6. civic activities 7. awards 8. credentials
55
What is transcription being streamed over a network with?
PDAs or hand-held personal computers
56
What are he typical tasks of a medical transcriptionist (6)
download and send files transcribe a medical report use references to check medical terms edit proofread and format a transcription query the professional who dictated the document make corrections marked by the HC professional who dictated the document
57
What are two trends in medical transcription. these also serve as alternatives to using in-house medical transcriptions
outsourcing of transcription to foreign countries such as India and Pakistan use of speech recognition technology
58
Why will medical transcriptions grow
increase in elderly | transition to electronic documentation
59
What is the professional organization for medical transcription
association for healthcare documentation integrity

Dynamics of Health Care (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions