CPB Certified Professional Biller Certification Practice Exam

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Which of the following terms refers to the likelihood of dying in the ARP-DRG system?

Severity of Illness (SOI)
Risk of Mortality (ROM)
Adverse Condition Assessment
Outcome Predictability Index

The correct answer is: Risk of Mortality (ROM)

The term that refers to the likelihood of dying in the ARP-DRG system is Risk of Mortality (ROM). In healthcare, particularly within the context of diagnosis-related groups (DRGs), ROM specifically assesses the probability that a patient will not survive their condition or the treatment process. This metric is essential for understanding patient outcomes and guiding decisions related to care management and resource allocation. Risk of Mortality is used as a critical benchmark to evaluate the complexity of patient cases, and it directly influences hospital reimbursement rates, quality assessment, and performance metrics. By quantifying mortality risk, healthcare providers can implement better risk management strategies, tailor treatment plans, and anticipate potential complications for high-risk patients. Understanding the concept of ROM within the ARP-DRG system is fundamental for billers and coders, as it helps ensure that the coding reflects the severity and complexity of the cases treated, thereby supporting accurate billing and healthcare reimbursement processes.