RHIT Exam Study Guide: Questions & Answers: RHIT Exam
Is not a step in developing a record retention schedule? - ANSWER:Assigning all records the same
retention period
Mr. Beasley determined that the rate of absenteeism with three of his employees was 15%. He felt that
this was unacceptable and decided that there were two different ways he could handle this situation. He
evaluated these alternatives and thought the best thing to do would be to suspend all three for 2 days.
Once he implemented this idea, he analyzed the consequences. How would you label this process? -
ANSWER:Decision Making
The surgeon comes out to speak to a patient's family. He tells them that the patient came through the
surgery fine. The mass was benign and they could see the patient in an hour. He talks low so the the
other people in the waiting room will not hear but someone walked by and heard. This is called a(n) -
ANSWER:Incidental disclosure
Microfilmed records are considered. - ANSWER:acceptable as courtroom evidence
North Port Health Center is moving to a new facility in 2014. The CEO is projecting a conversion to
paperless health records by then. This new facility will not include space for the filing of paper health
records. Which of the following items would not be considered when planning this conversion? -
ANSWER:Relationship with the microfilm vendor
The best source for obtaining data for a job analysis is the? - ANSWER:The person who performs the job
The HIM Department is asked to pull records for review by the Quality Improvement Organization (QIO).
The QIO reviewers analyze records to ensure that health care services are? - ANSWER:Rendered
according to appropriate professional standards.
Medically necessary
Performed in the most efficient, effective, and economical manner.
Which source is the most valuable to monitor Medicare changes? - ANSWER:Federal Register
Best summarizes the current treatment of cervical cancer? - ANSWER:A new three-shot vaccination
series against the types of HPV that cause most cervical cancer cases.
As supervisor of the record completion function of the HIM Department, you are asked for record
completion statistics for specific physicians who are being evaluated for reappointment to the medical
staff. This is the informational elements that would be reported for each? - ANSWER:Number of
delinquent records
A union campaign is being conducted at your facility. As a department manager, it is appropriate for you
to tell employees that? - ANSWER:You are opposed to the union
As the Coding supervisor, your job description includes working with agents who have been charged with
detecting and correcting overpayments made to your hospital in the Medicare Fee for Service Program.
You will need to develop a professional relationship with? - ANSWER:Recovery audit contractors
,Four patients were discharged from Crestview Hospital yesterday. A final progress note is an appropriate
discharge summary for? - ANSWER:Babson, who delivered a health 8 lb boy without complications for
either mother or child, and was discharged within 36 hours of admission
You are calculating the fee schedule payment amount for physician services covered under Medicare
Part B. You already have the relative value unit figure. The system you are likely referencing is? -
ANSWER:RBRVS
In reviewing a health record for coding purposes, the coder notes that the patient was put on Keflex post
surgery. There is no mention of a postoperative complication in the attending physician's discharge
summary. Before querying the doctor, the coder will seek to confirm the infection by reviewing the? -
ANSWER:Lab report
As a coder for a large physician practice, you have reason to believe that several physicians are involved
in charging Medicare for services not rendered. Regulatory oversight for complaints regarding this
fradulent activity lies with? - ANSWER:The Recovery Audit Contractor
Sunset Beach Clinic allows patients to communicate by e-mail to ask questions regarding their treatment
and request appointment changes. E-mails and text messages are? - ANSWER:Considered health care
business records and are subject to the same regulations as records created in face-to-face patient
encounters.
The facility's policy for physician's verbal orders in accordance with state law and regulations needs
updating. The first area of investigation is the qualifications of those individuals who have been
authorized to record verbal orders. For this information you will consult the? - ANSWER:hospital bylaws,
rules and regulations
Parker has type 1 diabetes with hypertension that is currently controlled with medication. Parker was
admitted through the ED for an emergency appendectomy. Following surgery, the patient developed an
infection at the wound site that was treated with antibiotics. When making decisions about sequencing
the codes for this case, the coder should rely on definitions found in the? - ANSWER:UHDDS (Uniform
Hospital Discharge Data Set) - The circumstances of inpatient admission always governs the selection of
principal diagnosis. The principal diagnosis is defined as the condition established after study to be
chiefly responsible for occasioning the admission of the patient to the hospital care.
Is coded as an adverse effect in ICD-10-CM? - ANSWER:Tinnitus due to allergic reaction after
administration of eardrops
Identifies a pathologic fracture? - ANSWER:Compression fracture of the vertebrae as a result of bone
metastasis
If the same condition is described as both acute and chronic and separate subentries exist in the ICD-10-
CM alphabetic index at the same indentation level? - ANSWER:They should both be coded, acute
sequenced first
A surgical operation may include one or more surgical procedures? - ANSWER:True statement
Is considered a late effect regardless of time? - ANSWER:Nonunion
,This diagnosis or procedure would prevent the normal delivery code, 080, from being assigned? -
ANSWER:low forceps
Progress note elements written in the acronym "Soap" style are: - ANSWER:S- Subjective; records what
the patient states is the problem
O- Objective; records what the practitioner identifies through history, physical examination and
diagnostic tests
A - Assessment; combines the subjective and objective into a conclusion
P - Plan; what approach is going to be taken to resolve the problem.
The condition should be coded as a poisoning when there is an interaction of an over-the-counter drug
and alcohol.
Coded as a poisoning? - ANSWER:Bryan developed syncope after taking Contac pills with a double
scotch.
The discharge diagnosis for this inpatient encounter is rule out myocardial infarction. The coder would
assign? - ANSWER:A code for a myocardial infarction
Staging? - ANSWER:Is a system for documenting the extent or spread of cancer.
Are always considered "present on admission" (POA)? - ANSWER:congenital conditions
In your state, it is legal for minors to seek medical treatment for a sexually transmitted disease without
parental consent. When this occurs, who would be expected to authorize the release of the medical
information documented in this episode of care to the patient's insurers? - ANSWER:The patient
A patient is admitted through the emergency department. Three days after admission, the physician
documents uncontrolled diabetes mellitus. What is the "present on admission" (POA) indicator for
uncontrolled diabetes mellitus? - ANSWER:N - not present on admission
A HIM Department, currently using 2,540 linear filing inches to store records, plans to purchase new
open shelf filing units. Each of the shelves in a new 6 shelf unit measures 36 linear filing inches. It is
estimated that an additional 400 filing inches should be planned for, to allow for 5 year expansion needs.
How many file shelving units should be purchased? - ANSWER:14
The main purpose of an electronic documentation management system (EDMS) is to? - ANSWER:Manage
documents
Dr. Smith goes to Hollywood Hospitals website and logs in. He sees a list of patients currently in the
hospital, test results and more. Mrs. Brown a patient of Dr. Smith's who is having surgery next week, logs
onto the same website and only sees the date and time of preoperative visit. This is an example of? -
ANSWER:Web portal
New employee orientation training most likely covers this HIPAA component? -
ANSWER:Physical/workstation security
Is a foreign key in the patient table? - ANSWER:Billing number
, Two types of budgets that are often prepared by mangers of the HIM Department? - ANSWER:Capital
budget and the operational or revenue and expense budget
When a decubitus ulcer has progressed to a stage in which osteomyelitis is present, the ulcer has
extended to the? - ANSWER:Bone
Kyle, the HIM Director, has received a request to amend a patient's medical record. The appropriate
action for him to take is? - ANSWER:Route the request to the physician who wrote the note in question
Mr. McDonaldson was admitted to your hospital at 10:45PM on January 1. He died at 4:22 AM on
January 3. How many inpatient service days did Mr. McDonaldson receive? - ANSWER:3 days
Which of the following tubes conveys sperm from the seminal vesicle to the urethra? -
ANSWER:Ejaculatory duct
A patient is admitted with SOB, and hempotysis. A chest x-ray revealed patchy infiltrates in the left lung
and possible pneumonia. On the third day of hospitalization a bronchoscopy with biopsy was done,
which revealed a small cell carcinoma of the left upper lobe of the lung. A metastatic lesion in the brain
was detected. The principal diagnosis is? - ANSWER:Small cell lung carcinoma
Harry Potter was admitted to your hospital to receive a second round of chemotherapy for an invasive
tumor. Four days after admission, Harry complained of a sore throat and developed a fever. Harry's
throat culture was positive for strep. His strep will be? - ANSWER:Added to the numerator of the
hospitals noscomial infection rate.
In compiling statistics to report the specific cause for all open heart surgery cases, the quality
coordinator assists in documenting? - ANSWER:Patient care outcomes
What is mean? - ANSWER:Is the arithmetic average.
85,73,93,99,78,81,93,88,93,72,77,87
Add up the total of all scores = 1019
The count of scores = 12
1019/12 = 84.9
What is median? - ANSWER:The midpoint of an ordered series of numbers arranged in numerical order
from highest to lowest or vice versa.
85,73,93,99,78,81,93,88,93,72,77,87
put numbers in order
72, 73, 77, 78, 81, 85, 87, 88, 93, 93, 93, 99
Because there is an even number of scores, take the two middle scores, which are 85 and 87 - add ten
together and divide the results by 2.
Is not a step in developing a record retention schedule? - ANSWER:Assigning all records the same
retention period
Mr. Beasley determined that the rate of absenteeism with three of his employees was 15%. He felt that
this was unacceptable and decided that there were two different ways he could handle this situation. He
evaluated these alternatives and thought the best thing to do would be to suspend all three for 2 days.
Once he implemented this idea, he analyzed the consequences. How would you label this process? -
ANSWER:Decision Making
The surgeon comes out to speak to a patient's family. He tells them that the patient came through the
surgery fine. The mass was benign and they could see the patient in an hour. He talks low so the the
other people in the waiting room will not hear but someone walked by and heard. This is called a(n) -
ANSWER:Incidental disclosure
Microfilmed records are considered. - ANSWER:acceptable as courtroom evidence
North Port Health Center is moving to a new facility in 2014. The CEO is projecting a conversion to
paperless health records by then. This new facility will not include space for the filing of paper health
records. Which of the following items would not be considered when planning this conversion? -
ANSWER:Relationship with the microfilm vendor
The best source for obtaining data for a job analysis is the? - ANSWER:The person who performs the job
The HIM Department is asked to pull records for review by the Quality Improvement Organization (QIO).
The QIO reviewers analyze records to ensure that health care services are? - ANSWER:Rendered
according to appropriate professional standards.
Medically necessary
Performed in the most efficient, effective, and economical manner.
Which source is the most valuable to monitor Medicare changes? - ANSWER:Federal Register
Best summarizes the current treatment of cervical cancer? - ANSWER:A new three-shot vaccination
series against the types of HPV that cause most cervical cancer cases.
As supervisor of the record completion function of the HIM Department, you are asked for record
completion statistics for specific physicians who are being evaluated for reappointment to the medical
staff. This is the informational elements that would be reported for each? - ANSWER:Number of
delinquent records
A union campaign is being conducted at your facility. As a department manager, it is appropriate for you
to tell employees that? - ANSWER:You are opposed to the union
As the Coding supervisor, your job description includes working with agents who have been charged with
detecting and correcting overpayments made to your hospital in the Medicare Fee for Service Program.
You will need to develop a professional relationship with? - ANSWER:Recovery audit contractors
,Four patients were discharged from Crestview Hospital yesterday. A final progress note is an appropriate
discharge summary for? - ANSWER:Babson, who delivered a health 8 lb boy without complications for
either mother or child, and was discharged within 36 hours of admission
You are calculating the fee schedule payment amount for physician services covered under Medicare
Part B. You already have the relative value unit figure. The system you are likely referencing is? -
ANSWER:RBRVS
In reviewing a health record for coding purposes, the coder notes that the patient was put on Keflex post
surgery. There is no mention of a postoperative complication in the attending physician's discharge
summary. Before querying the doctor, the coder will seek to confirm the infection by reviewing the? -
ANSWER:Lab report
As a coder for a large physician practice, you have reason to believe that several physicians are involved
in charging Medicare for services not rendered. Regulatory oversight for complaints regarding this
fradulent activity lies with? - ANSWER:The Recovery Audit Contractor
Sunset Beach Clinic allows patients to communicate by e-mail to ask questions regarding their treatment
and request appointment changes. E-mails and text messages are? - ANSWER:Considered health care
business records and are subject to the same regulations as records created in face-to-face patient
encounters.
The facility's policy for physician's verbal orders in accordance with state law and regulations needs
updating. The first area of investigation is the qualifications of those individuals who have been
authorized to record verbal orders. For this information you will consult the? - ANSWER:hospital bylaws,
rules and regulations
Parker has type 1 diabetes with hypertension that is currently controlled with medication. Parker was
admitted through the ED for an emergency appendectomy. Following surgery, the patient developed an
infection at the wound site that was treated with antibiotics. When making decisions about sequencing
the codes for this case, the coder should rely on definitions found in the? - ANSWER:UHDDS (Uniform
Hospital Discharge Data Set) - The circumstances of inpatient admission always governs the selection of
principal diagnosis. The principal diagnosis is defined as the condition established after study to be
chiefly responsible for occasioning the admission of the patient to the hospital care.
Is coded as an adverse effect in ICD-10-CM? - ANSWER:Tinnitus due to allergic reaction after
administration of eardrops
Identifies a pathologic fracture? - ANSWER:Compression fracture of the vertebrae as a result of bone
metastasis
If the same condition is described as both acute and chronic and separate subentries exist in the ICD-10-
CM alphabetic index at the same indentation level? - ANSWER:They should both be coded, acute
sequenced first
A surgical operation may include one or more surgical procedures? - ANSWER:True statement
Is considered a late effect regardless of time? - ANSWER:Nonunion
,This diagnosis or procedure would prevent the normal delivery code, 080, from being assigned? -
ANSWER:low forceps
Progress note elements written in the acronym "Soap" style are: - ANSWER:S- Subjective; records what
the patient states is the problem
O- Objective; records what the practitioner identifies through history, physical examination and
diagnostic tests
A - Assessment; combines the subjective and objective into a conclusion
P - Plan; what approach is going to be taken to resolve the problem.
The condition should be coded as a poisoning when there is an interaction of an over-the-counter drug
and alcohol.
Coded as a poisoning? - ANSWER:Bryan developed syncope after taking Contac pills with a double
scotch.
The discharge diagnosis for this inpatient encounter is rule out myocardial infarction. The coder would
assign? - ANSWER:A code for a myocardial infarction
Staging? - ANSWER:Is a system for documenting the extent or spread of cancer.
Are always considered "present on admission" (POA)? - ANSWER:congenital conditions
In your state, it is legal for minors to seek medical treatment for a sexually transmitted disease without
parental consent. When this occurs, who would be expected to authorize the release of the medical
information documented in this episode of care to the patient's insurers? - ANSWER:The patient
A patient is admitted through the emergency department. Three days after admission, the physician
documents uncontrolled diabetes mellitus. What is the "present on admission" (POA) indicator for
uncontrolled diabetes mellitus? - ANSWER:N - not present on admission
A HIM Department, currently using 2,540 linear filing inches to store records, plans to purchase new
open shelf filing units. Each of the shelves in a new 6 shelf unit measures 36 linear filing inches. It is
estimated that an additional 400 filing inches should be planned for, to allow for 5 year expansion needs.
How many file shelving units should be purchased? - ANSWER:14
The main purpose of an electronic documentation management system (EDMS) is to? - ANSWER:Manage
documents
Dr. Smith goes to Hollywood Hospitals website and logs in. He sees a list of patients currently in the
hospital, test results and more. Mrs. Brown a patient of Dr. Smith's who is having surgery next week, logs
onto the same website and only sees the date and time of preoperative visit. This is an example of? -
ANSWER:Web portal
New employee orientation training most likely covers this HIPAA component? -
ANSWER:Physical/workstation security
Is a foreign key in the patient table? - ANSWER:Billing number
, Two types of budgets that are often prepared by mangers of the HIM Department? - ANSWER:Capital
budget and the operational or revenue and expense budget
When a decubitus ulcer has progressed to a stage in which osteomyelitis is present, the ulcer has
extended to the? - ANSWER:Bone
Kyle, the HIM Director, has received a request to amend a patient's medical record. The appropriate
action for him to take is? - ANSWER:Route the request to the physician who wrote the note in question
Mr. McDonaldson was admitted to your hospital at 10:45PM on January 1. He died at 4:22 AM on
January 3. How many inpatient service days did Mr. McDonaldson receive? - ANSWER:3 days
Which of the following tubes conveys sperm from the seminal vesicle to the urethra? -
ANSWER:Ejaculatory duct
A patient is admitted with SOB, and hempotysis. A chest x-ray revealed patchy infiltrates in the left lung
and possible pneumonia. On the third day of hospitalization a bronchoscopy with biopsy was done,
which revealed a small cell carcinoma of the left upper lobe of the lung. A metastatic lesion in the brain
was detected. The principal diagnosis is? - ANSWER:Small cell lung carcinoma
Harry Potter was admitted to your hospital to receive a second round of chemotherapy for an invasive
tumor. Four days after admission, Harry complained of a sore throat and developed a fever. Harry's
throat culture was positive for strep. His strep will be? - ANSWER:Added to the numerator of the
hospitals noscomial infection rate.
In compiling statistics to report the specific cause for all open heart surgery cases, the quality
coordinator assists in documenting? - ANSWER:Patient care outcomes
What is mean? - ANSWER:Is the arithmetic average.
85,73,93,99,78,81,93,88,93,72,77,87
Add up the total of all scores = 1019
The count of scores = 12
1019/12 = 84.9
What is median? - ANSWER:The midpoint of an ordered series of numbers arranged in numerical order
from highest to lowest or vice versa.
85,73,93,99,78,81,93,88,93,72,77,87
put numbers in order
72, 73, 77, 78, 81, 85, 87, 88, 93, 93, 93, 99
Because there is an even number of scores, take the two middle scores, which are 85 and 87 - add ten
together and divide the results by 2.
