RHIA Exam 2 Domain 4 Questions and Answers 2024
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:
a. Granularity
b. Reliability
c. Timeliness
d. Accuracy
D. Ac...
RHIA Exam 2 Domain 4 Questions and Answers 2024
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:
a. Granularity
b. Reliability
c. Timeliness
d. Accuracy - answer D. Accuracy
After a claim has been filed with Medicare, a healthcare entity had late charges posted to a patient's outpatient account that changed the calculation of the ambulatory payment
classification (APC). What is the best practice for this entity to receive the correct reimbursement from Medicare?
a. Nothing, because the claim has already been submitted
b. Bill the patient for any remaining balance after payment from Medicare is received
c. Submit an adjusted claim to Medicare
d. Return the account to coding for review - answer C. Submit an adjusted claim to Medicare
The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is available for:
a. Veterans of the Armed Forces
b. Spouses or widow(er)s of veterans meeting specific criteria
c. Active-duty service members
d. Spouses of active-duty service members - answer B. Spouses or widow(er)s of veterans meeting specific criteria
Which of the following is the definition of revenue cycle management?
a. The regularly repeating set of events that produce revenue or income
b. The method by which patients are grouped together based on a set of characteristics
c. The systematic comparison of the products, services, and outcomes of one healthcare entity with those of a similar entity
d. The coordination of all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue - answer D. The coordination of all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue
Which of the following lists contains only entities that have roles in the various Medicare
Improper Payment Review processes?
a. MAC, RAC, and QIO
b. AMA, AHA, and RAC c. MAC, AMA, and QIO
d. ACS, MAC, and RAC - answer A. MAC, RAC, and QIO
What is the benefit of comparing the coding assigned by coders to the coding that appears on the claim?
a. May find that more codes are required to support the claim
b. May find that the charge description master soft coding is inaccurate
c. Serves as a way for HIM to take over the management of patient financial services
d. May find claim generation issues that cannot be found in other ways - answer D. May find claim generation issues that cannot be found in other ways
A polyp was removed from a patient's colon during a colonoscopy procedure. The physician and pathologist document the polyp as probable adenocarcinoma of the colon. Which of the following actions should the coding professional take to code this encounter?
a. Code "polyp"
b. Code "adenoma of the colon"
c. Code "adenocarcinoma of the colon"
d. Query the physician - answer A. Code "polyp"
Which of the following accreditation categories would the Joint Commission assign to a hospital that did not meet all of the standards at the time of the initial on-site survey, had
a level of standards in noncompliance, had Requirements for Improvements (RFIs) in excess of the published level for the year, and subsequently underwent an additional on-site, follow-up survey?
a. Accreditation with follow-up survey
b. Preliminary accreditation
c. Accredited
d. Contingent accreditation - answer D. Contingent Accreditation
When the physician does not specify the method used to remove a lesion during an endoscopy, what action should the coder take?
a. Assign the removal by snare technique code
b. Assign the removal by hot biopsy forceps code
c. Assign the ablation code
d. Query the physician as to the method used - answer D. Query the physician as to the method used
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
The term "hard coding" refers to:
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