AHIMA RHIT Practice Exam
Prospective Payment System - answer With this method of reimbursement, payment is
made based on a predetermined, fixed amount according to how it is assigned within a
classification system.
MS-DRGs
MS-DRSs categorize patients into medically related groups based on diagnosis,
severity, and treatment. - answer The prospective payment system that categorizes
patients who are medically related in respect to diagnosis, severity and treatment is:
Providers receive payment for services rendered - answer Fee-for-service is the
healthcare payment method described in which of the following scenarios:
Case Resource Consumption - answer Under a prospective payment system, payment
for healthcare is predetermined by:
Reduced payment to the transferring facility - answer CMS transfer policy generally
results in:
Procedures submitted by hospitals for inpatient encounters – answer CPT codes cannot
be reported on electronic healthcare claims transactions for ________.
Monitor the inpatient payment error rate - answerOne of the purposes of the Hospital
Payment Monitoring Program is to:
The patient health record lacks clinical indicators to support a request. - answerWhich of
the following is not a reason for a provider query for a more complete or accurate
diagnosis?
Code the surgical endoscopy only - answerCPT® defines a diagnostic endoscopy as a
"separate procedure." If a surgical endoscopy is performed in conjunction with the
diagnostic service, how should this scenario be coded?
If the condition mentioned in the note is documented as present, that diagnosis should
be coded - answerIn ICD-10-CM, the "use additional code" note indicates:
Consolidation Omnibus Budget Reconciliation Act of 1985 - answerWhich Act made it
possible for CMS to deny reimbursement for substandard healthcare services provided
to Medicare and Medicaid beneficiaries?
National Center for Health Statistics (NCHS) - answerWhich governmental agency is
responsible for maintaining the ICD-10-CM diagnosis codes?
Prospective Payment System - answer With this method of reimbursement, payment is
made based on a predetermined, fixed amount according to how it is assigned within a
classification system.
MS-DRGs
MS-DRSs categorize patients into medically related groups based on diagnosis,
severity, and treatment. - answer The prospective payment system that categorizes
patients who are medically related in respect to diagnosis, severity and treatment is:
Providers receive payment for services rendered - answer Fee-for-service is the
healthcare payment method described in which of the following scenarios:
Case Resource Consumption - answer Under a prospective payment system, payment
for healthcare is predetermined by:
Reduced payment to the transferring facility - answer CMS transfer policy generally
results in:
Procedures submitted by hospitals for inpatient encounters – answer CPT codes cannot
be reported on electronic healthcare claims transactions for ________.
Monitor the inpatient payment error rate - answerOne of the purposes of the Hospital
Payment Monitoring Program is to:
The patient health record lacks clinical indicators to support a request. - answerWhich of
the following is not a reason for a provider query for a more complete or accurate
diagnosis?
Code the surgical endoscopy only - answerCPT® defines a diagnostic endoscopy as a
"separate procedure." If a surgical endoscopy is performed in conjunction with the
diagnostic service, how should this scenario be coded?
If the condition mentioned in the note is documented as present, that diagnosis should
be coded - answerIn ICD-10-CM, the "use additional code" note indicates:
Consolidation Omnibus Budget Reconciliation Act of 1985 - answerWhich Act made it
possible for CMS to deny reimbursement for substandard healthcare services provided
to Medicare and Medicaid beneficiaries?
National Center for Health Statistics (NCHS) - answerWhich governmental agency is
responsible for maintaining the ICD-10-CM diagnosis codes?
