RHIT DOMAIN 4: REVENUE CYCLE
MANAGEMENT WITH COMPLETE
SOLUTIONS
The sum of a hospital's relative DRG weights for a year was 15,192, and the hospital
had 10,471 discharges for the year. Given this information, what would be the hospital's
case-mix index for that year? - ANSWER-1.45
n 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.
A patient was admitted to the hospital with symptoms of a stroke and secondary
diagnoses of COPD and hypertension. The patient was subsequently discharged from
the hospital with a principal diagnosis of cerebral vascular accident and secondary
diagnoses of catheter-associated urinary tract infection, COPD, and hypertension.
Which of the following diagnoses would be reported as POA? - ANSWER-Cerebral
vascular accident, COPD, Hypertension
Placenta previa with delivery of twins. This patient had two prior cesarean sections. She
also has a third-degree perineal laceration. This was an emergent C-section due to
hemorrhage associated with the placenta previa. The appropriate principal diagnosis
would be: - ANSWER-Placenta Previa
Local coverage determinations (LCD) describe when and under what circumstances
which of the following is met: - ANSWER-Medical necessity
If a physician does not provide a diagnosis to justify the medical necessity of a service,
the provider may obtain payment from the patient: - ANSWER-Only if a properly
executed ABN was obtained before the service was provided
Patient is admitted with prepatellar bursitis following a crushing injury to the left knee as
a result of being hit by a car two years ago. What diagnosis codes would be assigned
for this patient? - ANSWER-M70.42, S87.02xS
A patient was seen in the emergency department for chest pain. It was suspected that
the patient may have gastroesophageal reflux disease (GERD). The final diagnosis was
"Rule out GERD." The correct ICD-10-CM diagnosis code is: - ANSWER-R07.9, Chest
pain, unspecified
, Which of the following can be used to develop a focused inpatient coding review? -
ANSWER-Recent data quality issues identified by external review agencies
A patient is admitted for the treatment of dehydration secondary to chemotherapy for
primary liver cancer. IV fluids were administered to the patient. Which of the following
should be sequenced as the principal diagnosis? - ANSWER-Dehydration
In reviewing a patient chart, the coder finds that the patient's chest x-ray is suggestive of
chronic obstructive pulmonary disease (COPD). The attending physician mentions the
x-ray finding in one progress note, but no medication, treatment, or further evaluation is
provided. Which of the following actions should the coder take in this case? - ANSWER-
Query the attending physician and ask him to validate a diagnosis based on the chest x-
ray results
Query the attending physician and ask him to validate a diagnosis based on the chest x-
ray results - ANSWER-D23.12
Carolyn works as an inpatient coder in a hospital HIM department. She sees a lab
report in a patient's health record that is positive for staph infection. However, there is
no mention of staph in the physician's documentation. What should Carolyn do? -
ANSWER-Query the physician
City Hospital's Revenue Cycle Management team has established the following
benchmarks: (1) The value of discharged not final billed cases should not exceed two
days of average daily revenue, and (2) AR days are not to exceed 60 days. The net
average daily revenue is $1,000,000. The following data indicate that City Hospital's
DNFB cases met its benchmarks: - ANSWER-50 percent of the time
The accounts not selected for the billing report is used to track accounts that are: -
ANSWER-In bill hold or awaiting billing
A patient received a complete replacement of tunneled centrally inserted central venous
catheter with subcutaneous port; replacement performed through original access site
(45-year-old patient). Which of the following CPT codes would be most appropriate? -
ANSWER-36582
To clarify documentation, the preferred method of contact between a coder and a
physician is: - ANSWER-Face-to-face communication
The coder assigned separate codes for individual tests when a combination code exists.
This is an example of which of the following? - ANSWER-Unbundling
A patient had a placenta previa with delivery of twins. The patient had two prior
cesarean sections. This was an emergency C-section due to hemorrhage. The
appropriate principal diagnosis would be: - ANSWER-Placenta previa
MANAGEMENT WITH COMPLETE
SOLUTIONS
The sum of a hospital's relative DRG weights for a year was 15,192, and the hospital
had 10,471 discharges for the year. Given this information, what would be the hospital's
case-mix index for that year? - ANSWER-1.45
n 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.
A patient was admitted to the hospital with symptoms of a stroke and secondary
diagnoses of COPD and hypertension. The patient was subsequently discharged from
the hospital with a principal diagnosis of cerebral vascular accident and secondary
diagnoses of catheter-associated urinary tract infection, COPD, and hypertension.
Which of the following diagnoses would be reported as POA? - ANSWER-Cerebral
vascular accident, COPD, Hypertension
Placenta previa with delivery of twins. This patient had two prior cesarean sections. She
also has a third-degree perineal laceration. This was an emergent C-section due to
hemorrhage associated with the placenta previa. The appropriate principal diagnosis
would be: - ANSWER-Placenta Previa
Local coverage determinations (LCD) describe when and under what circumstances
which of the following is met: - ANSWER-Medical necessity
If a physician does not provide a diagnosis to justify the medical necessity of a service,
the provider may obtain payment from the patient: - ANSWER-Only if a properly
executed ABN was obtained before the service was provided
Patient is admitted with prepatellar bursitis following a crushing injury to the left knee as
a result of being hit by a car two years ago. What diagnosis codes would be assigned
for this patient? - ANSWER-M70.42, S87.02xS
A patient was seen in the emergency department for chest pain. It was suspected that
the patient may have gastroesophageal reflux disease (GERD). The final diagnosis was
"Rule out GERD." The correct ICD-10-CM diagnosis code is: - ANSWER-R07.9, Chest
pain, unspecified
, Which of the following can be used to develop a focused inpatient coding review? -
ANSWER-Recent data quality issues identified by external review agencies
A patient is admitted for the treatment of dehydration secondary to chemotherapy for
primary liver cancer. IV fluids were administered to the patient. Which of the following
should be sequenced as the principal diagnosis? - ANSWER-Dehydration
In reviewing a patient chart, the coder finds that the patient's chest x-ray is suggestive of
chronic obstructive pulmonary disease (COPD). The attending physician mentions the
x-ray finding in one progress note, but no medication, treatment, or further evaluation is
provided. Which of the following actions should the coder take in this case? - ANSWER-
Query the attending physician and ask him to validate a diagnosis based on the chest x-
ray results
Query the attending physician and ask him to validate a diagnosis based on the chest x-
ray results - ANSWER-D23.12
Carolyn works as an inpatient coder in a hospital HIM department. She sees a lab
report in a patient's health record that is positive for staph infection. However, there is
no mention of staph in the physician's documentation. What should Carolyn do? -
ANSWER-Query the physician
City Hospital's Revenue Cycle Management team has established the following
benchmarks: (1) The value of discharged not final billed cases should not exceed two
days of average daily revenue, and (2) AR days are not to exceed 60 days. The net
average daily revenue is $1,000,000. The following data indicate that City Hospital's
DNFB cases met its benchmarks: - ANSWER-50 percent of the time
The accounts not selected for the billing report is used to track accounts that are: -
ANSWER-In bill hold or awaiting billing
A patient received a complete replacement of tunneled centrally inserted central venous
catheter with subcutaneous port; replacement performed through original access site
(45-year-old patient). Which of the following CPT codes would be most appropriate? -
ANSWER-36582
To clarify documentation, the preferred method of contact between a coder and a
physician is: - ANSWER-Face-to-face communication
The coder assigned separate codes for individual tests when a combination code exists.
This is an example of which of the following? - ANSWER-Unbundling
A patient had a placenta previa with delivery of twins. The patient had two prior
cesarean sections. This was an emergency C-section due to hemorrhage. The
appropriate principal diagnosis would be: - ANSWER-Placenta previa
