RHIA Domain 4 Test | 105 Questions Solved 100% Correct
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RHIA Domain 4
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RHIA Domain 4
A coder notes that the patient is taking prescribed Haldol. The final diagnoses on the
progress notes include diabetes mellitus, acute pharyngitis, and malnutrition. What
condition might the coder suspect the patient has that the physician should be queried
to confirm? - Answer Mental or behavio...
RHIA Domain 4 Test | 105 Questions Solved
100% Correct
A coder notes that the patient is taking prescribed Haldol. The final diagnoses on the
progress notes include diabetes mellitus, acute pharyngitis, and malnutrition. What
condition might the coder suspect the patient has that the physician should be queried
to confirm? - Answer Mental or behavior problems
In conducting a qualitative review, the clinical documentation specialist sees that the
nursing staff has documented the patient's skin integrity on admission to support the
presence of a stage I pressure ulcer. However, the physician's documentation is unclear
as to whether this condition was present on admission. How should the clinical
documentation specialist proceed? - Answer Query the physician to determine if the
condition was present on admission
Phil White had coronary artery bypass graft surgery. Unfortunately, during the surgery,
Phil suffered a severe stroke. Phil's recovery included several settings in the continuum
of care: acute-care hospital, physician office, rehabilitation center, and home health
agency. This initial service and subsequent recovery lasted 10 months. As a member of a
managed care organization in an integrated delivery system, how should Phil expect
that his healthcare billing will be handled? - Answer One fixed amount for the entire
episode that is divided among all the physicians, facilities, and other healthcare
providers
The coding supervisor has compiled a report on the number of coding errors made each
day by the coding staff. The report data show that Tim makes an average of six errors
per day, Jane makes an average of five errors per day, and Bob and Susan each make an
average of two errors per day. Given this information, what action should the coding
supervisor take? - Answer Take no action since not enough information is given to make
a judgment
,Once all data has been posted to patient's account, the claim can be reviewed for
accuracy and completeness. Many facilities have an internal auditing system that runs
each claim through a set of edits. This internal auditing system is known as a: - Answer
Scrubber
Which of the following payment arrangements is streamlined by the use of
chargemasters?
a. Fee-for-service
b. Per diem
c. Prospective
d. Retrospective - Answer a. Fee-for-service
Which of the following would generally be found in a query to a physician?
a. Health record number and demographic information
b. Name and contact number of the individual initiating the query and account number
c. Date query initiated and date query must be completed
d. Demographic information and name and contact number of individual initiating the
query - Answer b. Name and contact number of the individual initiating the query and
account number
A ________ assists in educating medical staff members on documentation needed for
accurate billing. - Answer Physician advisor
A coding supervisor audits coded records to ensure the codes reflect the actual
documentation in the health record. This coding auditing process addresses the data
quality element of: - Answer Accuracy
The term "hard coding" refers to: - Answer CPT codes that appear in the hospital's
chargemaster
, Which type of identity theft occurs when a patient uses another person's name and
insurance information to receive healthcare benefits? - Answer Medical
A coding audit shows that an inpatient coder is using multiple codes that describe the
individual components of a procedure rather than using a single code that describes all
the steps of the procedure performed. Which of the following should be done in this
case?
a. Require all coders to implement this practice
b. Report the practice to the OIG
c. Counsel the coder to stop the practice immediately
d. Put the coder on an unpaid leave of absence - Answer c. Counsel the coder to stop
the practice immediately
In developing a coding compliance program, which of the following would not be
ordinarily included as participants in coding compliance education?
a. Current coding personnel
b. Medical staff
c. Newly hired coding personnel
d. Nursing staff - Answer d. Nursing staff
Aging of accounts is the practice of counting the days, generally in increments, from the
time a bill has been sent to the payer to the current day. What is the standard
increment, in days, that most healthcare entities use for the aging of accounts? - Answer
30-day increment
What is the benefit of comparing the coding assigned by coders to the coding that
appears on the claim? - Answer May find claim generation issues that cannot be found
in other ways
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