InterQual Quiz: Test Your IQ! Trivia

2.

Criteria points are clinical statements that refer to test results, medications, symptoms, findings, monitoring, medical management, functional status, and prescribed therapies. Criteria points support the reasons or indications; that is, they identify specific clinical elements that must be satisfied to justify the appropriateness of the intervention/service.

True
False

Correct Answer

A. True

Explanation

Criteria points are clinical statements that provide specific clinical elements that must be satisfied to justify the appropriateness of the intervention or service. These statements can refer to various aspects such as test results, medications, symptoms, findings, monitoring, medical management, functional status, and prescribed therapies. By having criteria points, healthcare professionals can ensure that the intervention or service is appropriate and necessary for the patient's condition. Therefore, the statement "Criteria points are clinical statements that refer to test results, medications, symptoms, findings, monitoring, medical management, functional status, and prescribed therapies" is true.

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1

3.

It is the reviewer's responsibility to choose the correct criteira set for reviewing the request.

True
False

Correct Answer

A. True

Explanation

The statement is true because the responsibility of choosing the correct criteria set for reviewing a request lies with the reviewer. The reviewer needs to carefully assess the request and determine the appropriate criteria that should be used to evaluate it. This ensures that the review process is fair, consistent, and aligned with the objectives and requirements of the request. By selecting the correct criteria set, the reviewer can make informed judgments and provide valuable feedback or recommendations on the request.

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4.

When conducting a review, the reviewer determines an indication for performing a procedure or intervention is not listed. What should the reviewer do?

Deny the request
Use clinical judgement and approve the request
Document the appropriate clinical information and send for secondary medical review
Choose a different indication

Correct Answer

A. Document the appropriate clinical information and send for secondary medical review

Explanation

When conducting a review, if the reviewer determines that an indication for performing a procedure or intervention is not listed, they should document the appropriate clinical information and send it for a secondary medical review. This is necessary to ensure that all relevant information is considered and to obtain a second opinion from another medical professional. It allows for a more thorough evaluation of the case and helps in making an informed decision regarding the request.

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1

5.

In Level of Care Home Care Criteria: When more than 1 service is requested and each will be provider by a different discipline, the reviewer must review each service seperately

True
False

Correct Answer

A. True

Explanation

When multiple services are requested in the Level of Care Home Care Criteria and each service will be provided by a different discipline, the reviewer must review each service separately. This means that the reviewer should evaluate each service individually, considering the specific requirements and criteria for that particular service. By doing so, the reviewer can ensure that each service is assessed accurately and appropriately, taking into account the unique aspects and considerations associated with each discipline.

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1

6.

InterQual Clinical Reference is accessible from the Help menu within IQ View and Review Manager. What materials are available? Choose the correct option:

Review Process-Provides information on criteria components, review process steps, and practical tips
Abbreviations and Symbols- A list of abbreviations and symbols contained in the criteria
Bibliography-includes references used to develop the criteria, lists alphabetically
Drug list-Generic and trade names of some medications that are referenced in the criteria and the notes
Clinical revision-Describe significant change to the clinical content of the criteria, including explanations for the rationale behind the revisions.
All of the above

Correct Answer

A. All of the above

Explanation

The InterQual Clinical Reference provides various materials accessible from the Help menu within IQ View and Review Manager. These materials include information on the review process, criteria components, and practical tips. It also includes a list of abbreviations and symbols used in the criteria, a bibliography of references used to develop the criteria, a drug list containing generic and trade names of referenced medications, and clinical revisions that describe significant changes to the criteria's clinical content and provide explanations for the revisions. Therefore, the correct answer is "All of the above."

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2

7.

To view and print InterQual Criteria, you use Book VIew.

True
False

Correct Answer

A. True

Explanation

The explanation for the given correct answer is that to view and print InterQual Criteria, you use Book View. This means that the statement "True" is correct as it accurately reflects the fact that Book View is the tool used for accessing and printing InterQual Criteria.

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3

8.

Which resource provides reminders of best clinical practices, new clinical knowledge, explanations of criteria rationale, definitions of medical terminology, and current literature references.

Clinical Revisions
Inpatient List
Drug List
Information notes located at the end of a criteria point

Correct Answer

A. Information notes located at the end of a criteria point

Explanation

The information notes located at the end of a criteria point provide reminders of best clinical practices, new clinical knowledge, explanations of criteria rationale, definitions of medical terminology, and current literature references. These notes serve as a valuable resource for healthcare professionals to stay updated on the latest clinical guidelines and evidence-based practices. They help ensure that healthcare providers are making informed decisions and providing high-quality care to their patients.

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1

9.

What is the primary purpose of InterQual criteria in healthcare?

To determine the best pharmaceutical products for a hospital
To set international qualifications for healthcare professionals
To guide healthcare providers in making evidence-based decisions about patient care
To establish billing protocols for international healthcare services

Correct Answer

A. To guide healthcare providers in making evidence-based decisions about patient care

Explanation

InterQual criteria are widely used in the healthcare industry to support decision-making on patient admissions, procedures, and treatments. Developed by McKesson, these criteria provide a framework for ensuring that patients receive appropriate care based on the latest evidence and best practices in medicine. InterQual helps healthcare providers determine the necessity and appropriateness of care based on clinical evidence, thereby optimizing patient outcomes and resource utilization. It is not involved with pharmaceutical product selection, setting qualifications for healthcare professionals, nor establishing billing protocols for services.

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0

10.

In the Durable Medical Equipment Criteria: When conducting a review, answering questions in a specific pathway will lead the user to Clinical Revisions.

True
False

Correct Answer

A. False

Explanation

When conducting a review in the Durable Medical Equipment Criteria, answering questions in a specific pathway will not lead the user to Clinical Revisions.

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2

11.

Choose the correct order to open the correct Guideline from the question above.

1,2,3,4
2,3,4,1
4,3, 1 or 2
None of the above

Correct Answer

A. 4,3, 1 or 2

Explanation

The correct order to open the correct guideline is 4, 3, 1 or 2. This means that first, you should open guideline number 4, then guideline number 3, and finally either guideline number 1 or guideline number 2. The order of opening guideline number 1 or 2 is not specified, so either one can be opened after guideline number 3.

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2

Interqual Quiz: Test Your IQ! Trivia

Expanding and Collapsing Criteria Criteria points may stand alone or be hierarchically embedded in a decision tree. You expand the decision tree by clicking the plus (+) sign to show the underlying criteria points. You collapse the decision tree by clicking the minus (-) sign.

Quiz Preview

It is the reviewer's responsibility to choose the correct criteira set for reviewing the request.

When conducting a review, the reviewer determines an indication for performing a procedure or intervention is not listed. What should the reviewer do?

In Level of Care Home Care Criteria: When more than 1 service is requested and each will be provider by a different discipline, the reviewer must review each service seperately

InterQual Clinical Reference is accessible from the Help menu within IQ View and Review Manager. What materials are available? Choose the correct option:

To view and print InterQual Criteria, you use Book VIew.

Which resource provides reminders of best clinical practices, new clinical knowledge, explanations of criteria rationale, definitions of medical terminology, and current literature references.

What is the primary purpose of InterQual criteria in healthcare?

In the Durable Medical Equipment Criteria: When conducting a review, answering questions in a specific pathway will lead the user to Clinical Revisions.

Choose the correct order to open the correct Guideline from the question above.