RHIA domain 4 Exam with Complete Solutions
The coder assigned separate codes for individual tests when a combination code exists. This is an example of which of the following?
a. Upcoding
b. Complex coding
c. Query
d. Unbundling - Answer-d. Unbundling
Community Hospital implemented a clinic...
RHIA domain 4 Exam with
Complete Solutions
The coder assigned separate codes for individual tests when a combination code exists.
This is an example of which of the following?
a. Upcoding
b. Complex coding
c. Query
d. Unbundling - Answer-d. Unbundling
Community Hospital implemented a clinical document improvement (CDI) program six
months ago. The goal of the program was to improve clinical documentation to support
quality of care, data quality, and HIM coding accuracy. Which of the following would be
best to ensure that everyone understands the importance of this program?
a. Request that the CEO write a memorandum to all hospital staff
b. Give the chairperson of the CDI committee authority to fire employees who do not
improve their clinical documentation
c. Include ancillary clinical staff and medical staff in the process
d. Request a letter of support from the Joint Commission - Answer-c. Include ancillary
clinical staff and medical staff in the process
The accounts receivable collection cycle involves the time from: - Answer-Admission to
deposit in the bank
In a typical acute-care setting, aging of accounts reports are monitored in which
revenue cycle area? - Answer-Accounts receivable
The lead coder in the HIM department is an acknowledged coding expert and is the go-
to person in the healthcare entity for coding guidance. As the HIM director you learn that
she is not following proper coding guidelines and her coding practices are not
compliant. As the HIM director, the best steps to take would be which of the following?
a. Report to the coder to the OIG and terminate the coder
b. Notify the compliance officer and suspend the employee
c. Review the coding errors and counsel the employee
d. Ignore the coding errors - Answer-c. Review the coding errors and counsel the
employee
To meet the definition of an inpatient rehabilitation facility (IRF), facilities must have an
inpatient population with at least a specified percentage of patients with certain
conditions. Which of the following conditions is counted in the definition?
, a. Brain injury
b. Chronic myelogenous leukemia
c. Acute myocardial infarction
d. Cancer - Answer-a. Brain injury
Medicaid coverage is not identical in New Jersey, California, and Idaho. Which of the
following reasons is correct?
a. Federal funds allocated to each state are based on the size of the state.
b. The program must cover infants born to Medicaid-eligible pregnant women.
c. States that offer an SCHIP program do not have a Medicaid program.
d. Medicaid allows states to maintain a unique program adapted to state residents'
needs and average incomes. - Answer-d. Medicaid allows states to maintain a unique
program adapted to state residents' needs and average incomes.
The process in which a healthcare entity addresses the provider documentation issues
of legibility, completeness, clarity, consistency, and precision is called: - Answer-Query
process
What is it called when accrediting bodies such as the Joint Commission can survey
facilities for compliance with the Medicare Conditions of Participation for hospitals
instead of the government? - Answer-Deemed status
Which of the following items are packaged under the Medicare hospital outpatient
prospective payment system (OPPS)?
a. Recovery room and medical visits
b. Medical visits and supplies (other than pass-through)
c. Anesthesia and ambulance services
d. Supplies (other than pass-through) and recovery room - Answer-d. Supplies (other
than pass-through) and recovery room
In terms of grouping and reimbursement, how are the MS-LTC-DRGs and acute-care
MS-DRGs similar? - Answer-Based on principal diagnosis
Which of the following elements is found in a charge description master?
a. ICD-10-CM code
b. Procedure or service charge
c. Patient disposition
d. Procedural service date - Answer-b. Procedure or service charge
Which of the following is used to reconcile accounts in the patient accounting
department?
a. Explanation of benefits
b. Medicare code editor
c. Preauthorization form
d. Fee schedule - Answer-a. Explanation of benefits
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