CNM Summer 2024 newsletter quiz - Malnutrition Coding Denials in the Acute Care Setting

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* 1. Please add your info.

Name:

Academy #:

Email address:

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* 2. The MS-DRG is assigned to a patient based on their:

a. Secondary diagnosis

b. Principal diagnosis

c. Malnutrition diagnosis

d. Relative weight

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* 3. Which of the following malnutrition codes is considered a major complication or comorbidity (MCC)?

a. E44

b. E44.1

c. E43

d. E46

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* 4. The APR-DRG system categorizes patients based on all of the following except:

a. MS-DRG code

b. Reason for admission

c. Severity of illness

d. Risk of mortality

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* 5. Which of the following is not a factor used to determine the facility’s blended rate?

a. Location

b. Patient acuity

c. Facility performance on quality measures

d. Number of beds

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* 6. To determine payment for a Medicare patient’s hospital stay, multiply the facility’s blended rate by:

a. Relative weight of the MS-DRG

b. Relative weight of the APR-DRG

c. Length of hospital stay

d. Severity of illness factor

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* 7. What organization is responsible for auditing Medicare payment claims?

a. Centers for Medicare and Medicaid Services

b. Academy of Nutrition and Dietetics

c. Medicaid

d. Office of the Inspector General

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* 8. Common reasons for malnutrition coding denials include all of the following except:

a. Clinician and auditor are using different malnutrition criteria

b. Documentation does not indicate that malnutrition impacted patient care

c. Physician does not document the ICD-10 code

d. Documentation between providers is contradictory

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* 9. Examples of inconsistent documentation include all of the following except:

a. RDN and physician document different malnutrition severity

b. RDN documents poor intake and RN records 100% intake of meals

c. RDN and physician document different malnutrition codes

d. RDN documents muscle wasting and physician documents well nourished

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* 10. Strategies to improve malnutrition documentation include all of the following except:

a. Include providers, clinical documentation integrity specialists, and coders in process improvement efforts

b. Document supporting evidence only if it is part of the approved malnutrition criteria

c. Adopt validated malnutrition criteria to be used by all clinicians.

d. Use electronic health record functionality to enhance communication of the malnutrition diagnosis and care plan

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* 11. All of the following should be included in an appeal except:

a. Actual cost of the patient’s care

b. Policy identifying approved malnutrition criteria

c. Documentation of nutrition interventions that increased costs of care

d. Documentation malnutrition contributing to poor patient outcomes