Health Information Management & Data Accuracy Flashcards
6 cards from real CCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Health Information Management & Data Accuracy flashcards as text
What is the primary purpose of the Master Patient Index (MPI)?
Answer: To uniquely identify each patient and link all their records across encounters
The MPI is the permanent database that assigns a unique medical record number to each patient and links all their visits and records within a health system, ensuring record integrity.
Which data quality characteristic ensures that health information is available when needed by authorized users?
Answer: Accessibility
Accessibility refers to data being available and retrievable by authorized users when needed - a core characteristic of high-quality health information.
A hospital's inpatient coding is found to have a 12% query rate for physician clarification. What does this primarily indicate?
Answer: Clinical documentation is frequently insufficient to code accurately without clarification
A high physician query rate indicates that clinical documentation lacks the specificity or completeness needed for accurate coding, requiring coders to ask physicians for clarification.
Under HIPAA, what is the minimum necessary standard as it applies to health information access?
Answer: Covered entities must make reasonable efforts to limit PHI access to the minimum needed for the intended purpose
The minimum necessary standard requires covered entities to limit PHI use, disclosure, and requests to the minimum amount necessary to accomplish the intended purpose.
What does the Health Insurance Portability and Accountability Act (HIPAA) transaction code set standard mandate for claims submission?
Answer: Electronic healthcare transactions must use HIPAA-mandated standard formats (X12 transactions)
HIPAA's administrative simplification provisions mandate that covered entities use X12 standard electronic transaction formats (e.g., 837P, 837I) for electronic claims submission.
A health information manager discovers that 200 records have been accessed by an employee without a treatment, payment, or operations purpose. Under HIPAA, this constitutes:
Answer: A breach requiring assessment under the Breach Notification Rule
Unauthorized access to PHI is a potential breach under HIPAA. The covered entity must conduct a breach risk assessment and may be required to notify affected individuals and HHS.