PTCIP: all the coding ever

Question 1

What is the Triple Aim of healthcare?

Answer 1

experience
quality
cost

Question 2

What is the Iron Triangle of healthcare

Answer 2

access
cost
quality

Question 3

“A state of complete physical, mental, and social well being and not merely the absence of disease.” This is a definition of what and created by Whom?

Answer 3

Health
World Health Orgination
1950s

Question 4

Term for the attributes of settings where care is delivered? Examples?

Answer 4

Structure

EMR, clinical specialization

Question 5

Term for whether or not good medical practices are followed? Examples?

Answer 5

Process

Screening for falls

Question 6

Term for measuring impact of care on health status?

Answer 6

Outcome

Question 7

What are the three population characteristics that determine use of healthcare?

Answer 7

predisposing characteristics
enabling resources
need

Question 8

What does conditional direct access mean?

Answer 8

neuromuscular conditions only

patient can come to PT only for 30 days without a script from physician

Question 9

What is construct validity?

Answer 9

construct: abstract concept invented to represent unobservable behaviors or ideas: no one way I can measure function, ex: LEFS

Question 10

What is content validity?

Answer 10

includes all characteristics it says it measures, expert panel, etc

Question 11

What is face validity?

Answer 11

appears to measure what is intended to measure, you look at the measure and think it makes sense

Question 12

What are three types of construct validity?

Answer 12

convergent
discriminant
know-groups validity

Question 13

What is convergent validity?

Answer 13

correlates with another thought to measure construct, ex: i compared it to a previous test and showed those results

Question 14

What is discriminant validity?

Answer 14

does not correlate w a measure assessing distinctively different characteristics: using a mental health component in a PT study

Question 15

What is know-groups validity?

Answer 15

Produces different scores for different groups known to be different.
Ex: surgical vs. non-surgical patients, acute vs. chronic

Question 16

What is criterion validity?

Answer 16

comparing to a gold standard

Question 17

What are the 3 vestibular reflexes?

Answer 17

VOR: vestibulo-ocular
VSR: vestibulospinal
VCR: vestibulocollic

Question 18

What is angular (rotational) VOR responsible for ?

Answer 18

compensates for rotation

nystagmus

Question 19

What mediates the VOR?

Answer 19

Mediated by SCCs (semicircular canals)

Question 20

What is the normal response of nystagmus? How would you name it?

Answer 20

postrorotary nystagmus
direction of nystagmus will be opposite to direction of rotation
ex: turn head l, you will have r nystagmus

Question 21

Does the vestibular system habituate during constant movement?
What compliments this?

Answer 21

Yes, the optokinetic reflex.

Optokinetic reflex generated by cerebral cortex

Question 22

Which sensory organ mediates the ocular tilt reflex, compensates for head tilt, and creates a counter-rolling response? How does this benefit you?

Answer 22

utricle

allows you to tilt head, but still see target in front of you

Question 23

What happens in Barany Testing? What is it measuring?

Answer 23

Rotation: 10 turns in 20 seconds

Postrotary nystagmus

Question 24

What is the Anti-kick Back Statute?

Answer 24

Protects patients and federal health-care programs from fraud and abuse by eliminating the corrupting influence of money.
Prohibits exchange or remuneration for services payable by the federal gov’t and prohibits behaviors that induce reward, or generate business.

Question 25

What law prohibits physicians from referring patients to certain designated health services to facilities in which they or a their close family member has a financial relationship?

Answer 25

Stark Law

Question 26

What does the False Claims Act do? Who created it?

Answer 26

Created by President Lincoln. | Identifies punishment for individuals that submit claims that are knowingly false.

Question 27

What law is required by the Office of the Inspector General that is designed to help protect and detect potential violations; includes a code of conduct, and provides a method for employees to report behavior in question and a process of investigation and correction?

Answer 27

Corporate Compliance Plan

Question 28

In PA specifically, what law defines the scope of PT practice, id's standards of profession conduct and defines actions that result in further investigation and judgement of professional misconduct?

Answer 28

PA State Practice Act

Question 29

What does the Medicare rate reduction do?

Answer 29

Medicare will pay for the most expensive procedure, but then each subsequent unit will be reimbursed less.``

Question 30

What is a KX modifier?

Answer 30

needed after $2040 of services are provided to indicate that services continue to be medically necessary and remain skilled. pt and speech combined, ot separate

Question 31

What is cost-based reimbursement called?

Answer 31

fee for service

Question 32

What are three types of prospective payment systems?

Answer 32

diagnostic related groups (drg) resource utilization groups (rug) ambulatory payment classifications (apc)

Question 33

What type of prospective payment system is used in acute care facilities

Answer 33

diagnostic related groups (drg) | very specific patient groups

Question 34

What type of prospective payment system is used in home health care?

Answer 34

HHRG, will get a lump sum determined by an OASIS form

Question 35

What type of prospective payment system is used in a SNF?

Answer 35

resource utilization group (rug)

Question 36

What type of payment system is used in outpatient?

Answer 36

fee for service/ohpps

Question 37

What is capitation?

Answer 37

a payment arrangement for health care service providers such as physicians or nurse practitioners

Question 38

What is an example of a capitation model?

Answer 38

Accountable Care Organizations

Question 39

What is an accountable care organization?

Answer 39

"provider-led organization whose mission is to manage the full continuum of care and be accountable for overall costs and quality of care for a defined population"

Question 40

What type of payment system is used in an inpatient rehab facility?

Answer 40

irf-pai

Question 41

What type of payment system is used in LTCH (long term care facilities)?

Answer 41

diagnosis related group (drg)