Certified Revenue Cycle Representative (CRCR) Practice Exam

What is a principal diagnosis?

1. Primary reason for the patient's admission

2. Secondary condition impacting patient care

3. Condition based on patient history

4. Diagnosis that has the longest duration

The correct answer is: Primary reason for the patient's admission

The principal diagnosis is defined as the primary reason for a patient's admission to a healthcare facility for treatment. This diagnosis is usually determined after reviewing the patient's condition and the circumstances surrounding the admission. It serves as a critical factor for billing and helps healthcare providers prioritize treatment plans, as it reflects the condition that necessitated the patient's stay in the healthcare facility. This diagnosis is essential for accurately capturing the patient's medical necessity for services rendered, impacting reimbursement decisions and ensuring compliance with regulatory requirements. The other options pertain to different aspects of a patient’s health but do not accurately define the principal diagnosis. A secondary condition may influence care but is not the main reason for admission. A condition based on patient history is important for a comprehensive understanding of the patient's health but is not necessarily the reason for the current admission. Similarly, the length of duration of a diagnosis may provide context but does not define the principal diagnosis itself.