SET 2026 ANSWERS GUARANTEED PASS
⫸ Procedure-to-Procedure (PTP) Edits review claims for codes that
report Answer: procedures that cannot or should not be provided to the
same patient on the same day.
⫸ It is September 15th, and you have just received the upcoming year's
ICD-10-PCS code set updates. The next step is to ________. Answer:
put in a change ticket for the hospital's chargemaster to be updated
⫸ You are conducting an educational session on benchmarking. You
tell your audience that the key to benchmarking is to use the comparison
to Answer: improve your department's processes.
⫸ A physician has come to the HIM department because he wants a
new smartphone to be able to access patient records. This way he can
enter orders when he is outside of the hospital. You need to direct the IT
department to Answer: encrypt the phone so access is protected.
⫸ The APC payment system is based on what coding system(s)?
Answer: CPT/HCPCS codes
, ⫸ The Joint Commission requires that all medical records be completed
within ___________ following patient discharge. Answer: 30 days
⫸ You have been hired to work with a computer-assisted coding (CAC)
initiative. The technology that you will be working with is Answer:
natural language processing.
⫸ External audits may be conducted by several organizations in the
federal government as well as the private sector, including ________.
Answer: Humana Fraud Department
RAC
OIG
⫸ When writing a query to a physician regarding ambiguous details in
the documentation, one must be careful to never let the question
Answer: imply an answer that will lead to a higher reimbursement rate.
⫸ If the National Coverage Determination indicates that Medicare will
not pay for a specific procedure, you may have to have the patient sign
Answer: an Advance Beneficiary Notice (ABN).
⫸ All health care facilities are obligated by federal legislation to
provide a safe and protected workplace for all staff and volunteers. This
legislation is known as Answer: OSHA.