CHDA 2024 UPDATE COMPREHENSIVE QUESTIONS
AND ANSWERS EXAM PREPARATION/STUDY GUIDE
[GET ALL 100% CORRECT]
Ambulatory payment classification (APC)
The payment unit used in the hospital outpatient prospective payment system (OPPS).
The classification is a resource-based reimbursement system.
Analysis
Reviewing and summarizing data for use in decision making.
Analysis of variance
The statistical tool used to compare more than two population means. The null
hypothesis tests that all of the population means are equal.
Auditing
"The performance of internal and external reviews (audits) to identify variations from
established baselines (for example, review of outpatient coding as compared with CMS
outpatient coding guidelines)."
Alpha level
The level of Type I error that is deemed acceptable based on context in statistical
hypothesis testing. See Type I error.
Alternative hypothesis
The complement of the null hypothesis that is to be tested using the appropriate
statistical test. This hypothesis typically requires some action to be taken.
Balanced design
An experimental design where the number of subjects in each sample are the same for
all populations sampled. The term is relevant when performing an analysis of variance
or a two sample t-test.
Bell curve
The shape of the normal distribution. The bell pealcs at the average and slopes down
on both sides symmetrically.
Binomial variable
"A variable that talces only two values (such as yes or no; alive or dead). The probability
of a yes or no is constant across all of the subjects, and the outcome of each subject is
independent of the others."
Case Mix Index (CMI)
"The average relative weight of all cases treated at a given facility or by a given
physician, which reflects the resource intensity or clinical severity of a specific group in
relation to the other groups in the classification system; calculated by dividing the sum
of the weights of diagnosis-related groups for patients discharged during a given period
by the total number of patients discharged."
Centers for Medicare and Medicaid Services (CMS)
,"The division of the Department of Health and Human Services that is responsible for
developing healthcare policy in the United States, for administering the Medicare
program and the federal portion of the Medicaid program, and maintaining the
procedure portion of the International Classification of Diseases, ninth revision, Clinical
Modification (ICD-9-CM) and International Classification of Diseases, tenth revision,
Procedure Coding System (ICD-10-PCS); called the Health Care Financing
Administration (HCFA) prior to 2001."
Chi squared test
A statistical test that is used to test for relationships between categorical variables. The
null hypothesis for this test is that there is no association between the two variables.
Represented by the symbol X2 (where X is the Greek letter chi.)
Cluster random sampling
"The population is divided into groups before the sample is selected. The groups or
clusters must be mutually exclusive and exhaustive. (That is, every unit in the
population is assigned to one and only one cluster.) Clusters are then randomly
selected to make up the sample. Cluster sampling may be performed as single-stage or
two-stage."
Cluster Sampling
Sampling where population is divided into groups (or clusters); groups are then
randomly selected to form sample
CMS-1500
"1. The universal insurance claim form developed and approved by the American
Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS)
that physicians use to bill Medicare, Medicaid, and private insurers for professional
services provided 2. A Medicare claim form used to bill third-party payers for provider
services, for example, physician office visits."
Coefficient of determination
"A statistic that measures the amount of variance in a dependent variable explained by
one or more independent variables. If there is one independent variable, then this value
is the Pearson Correlation Coefficient squared."
Confidence interval
An interval that is centered at the sample estimate of a population value that may be
calculated so that it has a preset probability of containing the population value.
Confidence level
The probability that a confidence interval includes the true value of a population statistic.
Contingency tables
A useful method for displaying the relationship between two categorical variables. Each
category is displayed as rows or columns. The cells in the table represent the count of
subjects with each category attribute.
Convenience sampling
A sampling technique where the selection of units from the population is based on easy
availability and/or accessibility.
Correlation
A statistic that is used to describe the association or relationship between two
continuous variables.
Critical value
, The value that a test statistic must be larger than to conclude statistical significance.
The value is based on the alpha level of the test and the distribution of the test statistic if
the null hypothesis is true.
Current Procedural Terminology (CPT)
"A comprehensive, descriptive list of terms and associated numeric and alphanumeric
codes used for reporting diagnostic and therapeutic procedures and other medical
services performed by physicians; published and updated annually by the American
Medical Association."
Data
"The dates, numbers, images, symbols, letters, and words that represent basic facts
and observations about people, processes, measurements, and conditions."
Data dictionary
"A descriptive list of the names, definitions, and attributes of data elements to be
collected in an information system or database whose purpose is to standardize
definitions and ensure consistent use."
Data mining
The process of extracting and analyzing large volumes of data from a database for the
purpose of identifying hidden and sometimes subtle relationships or patterns and using
those relationships to predict behaviors.
Data or Proc
Occur first in a SAS statement
Database
"A self-describing collection of integrated records. Each record has multiple attributes,
and each attribute has one or more values per entry. The database is self describing
because it contains a description of its own structure, and it is integrated because it has
a relationship between the data items."
Descriptive statistics
"A set of statistical techniques used to describe data such as means, frequency
distributions, and standard deviations; statistical information that describes the
characteristics of a specific group or a population."
Diagnosis-related group (DRGs)
"A unit of case-mix classification adopted by the federal government and some other
payers as a prospective payment mechanism for hospital inpatients in which diseases
are placed into groups because related diseases and treatments tend to consume
similar amounts of healthcare resources and incur similar amounts of cost; in the
Medicare and Medicaid programs, one of more than 500 diagnostic classifications in
which cases demonstrate similar resource consumption and length-of-stay patterns.
Under the prospective payment system (PPS), hospitals are paid a set fee for treating
patients in a single DRG category, regardless of the actual cost of care for the
individual."
Diagnostic data
The data obtained when diagnoses or reasons for visit are coded with a diagnostic
classification system.
Distribution
The pattern of values for a variable. The distribution may be characterized by center
and spread or frequency of values.
AND ANSWERS EXAM PREPARATION/STUDY GUIDE
[GET ALL 100% CORRECT]
Ambulatory payment classification (APC)
The payment unit used in the hospital outpatient prospective payment system (OPPS).
The classification is a resource-based reimbursement system.
Analysis
Reviewing and summarizing data for use in decision making.
Analysis of variance
The statistical tool used to compare more than two population means. The null
hypothesis tests that all of the population means are equal.
Auditing
"The performance of internal and external reviews (audits) to identify variations from
established baselines (for example, review of outpatient coding as compared with CMS
outpatient coding guidelines)."
Alpha level
The level of Type I error that is deemed acceptable based on context in statistical
hypothesis testing. See Type I error.
Alternative hypothesis
The complement of the null hypothesis that is to be tested using the appropriate
statistical test. This hypothesis typically requires some action to be taken.
Balanced design
An experimental design where the number of subjects in each sample are the same for
all populations sampled. The term is relevant when performing an analysis of variance
or a two sample t-test.
Bell curve
The shape of the normal distribution. The bell pealcs at the average and slopes down
on both sides symmetrically.
Binomial variable
"A variable that talces only two values (such as yes or no; alive or dead). The probability
of a yes or no is constant across all of the subjects, and the outcome of each subject is
independent of the others."
Case Mix Index (CMI)
"The average relative weight of all cases treated at a given facility or by a given
physician, which reflects the resource intensity or clinical severity of a specific group in
relation to the other groups in the classification system; calculated by dividing the sum
of the weights of diagnosis-related groups for patients discharged during a given period
by the total number of patients discharged."
Centers for Medicare and Medicaid Services (CMS)
,"The division of the Department of Health and Human Services that is responsible for
developing healthcare policy in the United States, for administering the Medicare
program and the federal portion of the Medicaid program, and maintaining the
procedure portion of the International Classification of Diseases, ninth revision, Clinical
Modification (ICD-9-CM) and International Classification of Diseases, tenth revision,
Procedure Coding System (ICD-10-PCS); called the Health Care Financing
Administration (HCFA) prior to 2001."
Chi squared test
A statistical test that is used to test for relationships between categorical variables. The
null hypothesis for this test is that there is no association between the two variables.
Represented by the symbol X2 (where X is the Greek letter chi.)
Cluster random sampling
"The population is divided into groups before the sample is selected. The groups or
clusters must be mutually exclusive and exhaustive. (That is, every unit in the
population is assigned to one and only one cluster.) Clusters are then randomly
selected to make up the sample. Cluster sampling may be performed as single-stage or
two-stage."
Cluster Sampling
Sampling where population is divided into groups (or clusters); groups are then
randomly selected to form sample
CMS-1500
"1. The universal insurance claim form developed and approved by the American
Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS)
that physicians use to bill Medicare, Medicaid, and private insurers for professional
services provided 2. A Medicare claim form used to bill third-party payers for provider
services, for example, physician office visits."
Coefficient of determination
"A statistic that measures the amount of variance in a dependent variable explained by
one or more independent variables. If there is one independent variable, then this value
is the Pearson Correlation Coefficient squared."
Confidence interval
An interval that is centered at the sample estimate of a population value that may be
calculated so that it has a preset probability of containing the population value.
Confidence level
The probability that a confidence interval includes the true value of a population statistic.
Contingency tables
A useful method for displaying the relationship between two categorical variables. Each
category is displayed as rows or columns. The cells in the table represent the count of
subjects with each category attribute.
Convenience sampling
A sampling technique where the selection of units from the population is based on easy
availability and/or accessibility.
Correlation
A statistic that is used to describe the association or relationship between two
continuous variables.
Critical value
, The value that a test statistic must be larger than to conclude statistical significance.
The value is based on the alpha level of the test and the distribution of the test statistic if
the null hypothesis is true.
Current Procedural Terminology (CPT)
"A comprehensive, descriptive list of terms and associated numeric and alphanumeric
codes used for reporting diagnostic and therapeutic procedures and other medical
services performed by physicians; published and updated annually by the American
Medical Association."
Data
"The dates, numbers, images, symbols, letters, and words that represent basic facts
and observations about people, processes, measurements, and conditions."
Data dictionary
"A descriptive list of the names, definitions, and attributes of data elements to be
collected in an information system or database whose purpose is to standardize
definitions and ensure consistent use."
Data mining
The process of extracting and analyzing large volumes of data from a database for the
purpose of identifying hidden and sometimes subtle relationships or patterns and using
those relationships to predict behaviors.
Data or Proc
Occur first in a SAS statement
Database
"A self-describing collection of integrated records. Each record has multiple attributes,
and each attribute has one or more values per entry. The database is self describing
because it contains a description of its own structure, and it is integrated because it has
a relationship between the data items."
Descriptive statistics
"A set of statistical techniques used to describe data such as means, frequency
distributions, and standard deviations; statistical information that describes the
characteristics of a specific group or a population."
Diagnosis-related group (DRGs)
"A unit of case-mix classification adopted by the federal government and some other
payers as a prospective payment mechanism for hospital inpatients in which diseases
are placed into groups because related diseases and treatments tend to consume
similar amounts of healthcare resources and incur similar amounts of cost; in the
Medicare and Medicaid programs, one of more than 500 diagnostic classifications in
which cases demonstrate similar resource consumption and length-of-stay patterns.
Under the prospective payment system (PPS), hospitals are paid a set fee for treating
patients in a single DRG category, regardless of the actual cost of care for the
individual."
Diagnostic data
The data obtained when diagnoses or reasons for visit are coded with a diagnostic
classification system.
Distribution
The pattern of values for a variable. The distribution may be characterized by center
and spread or frequency of values.
