Entire brain may be affected by autism

AORN Journal,  Oct, 2006  

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Autism may affect the functioning of virtually the entire brain, according to an Aug 16, 2006, news release from the National Institutes of Health. Previous research has shown that autism affects the brain areas involved with social interactions, communication behaviors, and reasoning abilities. Within the last 20 years, however, researchers have widened their focus to include other areas of brain functioning and have found that people with autism have trouble in other areas, including balance, movement, memory, and visual perception skills. Researchers now believe that autism is a disease in which different parts of the brain have trouble working together to perform complex tasks.

A group of 56 children aged 8 to 15 years with higher-functioning autism (ie, intelligence quotient of 80 or above and the ability to speak, write, and read) were given a series of neuropsychotogical tests. The results were compared to the responses of 56 children who did not have autism to help identify any patterns in mental functioning unique to autism.

Researchers found that children with autism performed as well as children without autism on the tests involving basic functioning, but they had difficulty doing complex tasks. For example, the children with autism completed simple tasks regarding visual and spatial skills, such as finding small objects in a cluttered visual field, with ease. Complex tasks such as telling the difference between the faces of similar looking people, however, were difficult for the children with autism. In addition, the children with autism exhibited the following characteristics.

* They were good at remembering the detail of a story, but they had trouble comprehending the story.

* They were proficient in spelling and grammar, but they had difficulty understanding complex ideas, such as idioms and metaphors.

* They either had poor handwriting or wrote slowly.

* They had trouble tying their shoes or using scissors.

These findings show that autism involves many different aspect of brain functioning and that subsequent research regarding the causes of autism must examine multiple brain areas.

Study Provides Evidence That Autism Affects Functioning of Entire Brain (news release, Bethesda, Md: National Institutes of Health, Aug 15, 2005) http://www.nih.gov/news/pr/aug2006/nichd-16.htm (accessed 8 Sept 2005).

Examination

The revenue cycle: What it is, how it works, and how to enhance it.

1. According to a 2003 study, healthrelated claims are denied because of problems with

1. billing errors.

2. eligibility.

3. lack of medical necessity for a procedure.

4. noncovered benefits.

a. 1 and 3

b. 2 and 4

c. 2, 3, and 4

d. 1, 2, 3, and 4

2. Diagnosis-related groups (DRGs)

1. are assigned by health information management personnel.

2. are assigned for both inpatient and out-patient procedures.

3. classify into groups all medical procedures expected to use similar resources.

4. provide a basis for Medicare reimbursement of inpatient stays.

5. represent common diagnoses, procedures, complications, and comorbidities.

a. 1 and 2

b. 3, 4, and 5

c. 1, 3, 4, and 5

d. 1, 2, 3, 4, and 5

3. A Medicare DRG add-on or additional payment is allowed for

1. facilities that have a high proportion of low-income patients.

2. facilities that incur indirect costs for medical education.

3. outlier cases that are unusually costly to a hospital.

4. implants with a C-code.

a. 1 and 3

b. 2 and 4

c. 1, 2, and 3

d. 1, 2, 3, and 4

4. A capitation amount that is contracted on a per patient/per month basis is paid regardless of how much care actually is provided.

a. true

b. false

5. Commonly negotiated carve-outs are

a. fixed facility charges.

b. implants or special devices and expensive medications.

c. capital equipment.

d. room and bed, x-rays, and all pharmacology products.

6. Revenue codes

1. are required for payers to process a bill.

2. help insurance companies identify charges on a bill.

3. help the health care facility's finance department generate an annual cost report.

4. identify what department will be credited when the item is reimbursed.

5. identify where a service was performed.

a. 1, 2, and 3

b. 4,5, and 6

c. 1, 2, 3, and 5

d. 1, 2, 3, 4, and 5

7. All items in a chargemaster and charged to a patient's account will have a Healthcare Common Procedural Coding System/Current Procedural Terminology code.

a. true

b. false

8. Insurance denials may be based on timely filing agreements set forth in the contract.

a. true

b. false

9. Ambulatory payment classification groups are based on the

1. body system involved.

2. costs of performing the service.

3. time it takes to provide services.

4. type of service provided.

5. relative weight assigned.

a. 1 and 3

b. 2, 3, and 4

c.1, 2, and 5

d. 1, 2, 3, and 4

10. Imparting knowledge of the revenue cycle to all facility staff members can

1. assist perioperative nurses as they make decisions regarding the purchase of items for the health care organization.