CHFM Study Guide 2025/2026 Exam
Questions Marking Scheme New Update
| A+ Rated
A HIPPS (Health Insurance Prospective Payment System) code is a five-character
alphanumeric code. A HIPPS code is used by: - 🧠 ANSWER ✔✔Home Health
Agencies (HHA)
and
Inpatient Rehabilitation Facilities (IRF)
A discharge in which the patient was discharged from the inpatient rehabilitation
facility and returned within three calendar days (prior to midnight on the third day)
is called a (n): - 🧠 ANSWER ✔✔Interrupted Stay
A fiscal year is a yearly accounting period. It is the 12-month period on which a
budget is planned. The federal fiscal year is: - 🧠 ANSWER ✔✔October 1st through
September 20th of the next year
A new initiative by the government to eliminate fraud and abuse and recover over-
payments involves the use of __________. Charts are audited to identify Medicare
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
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,over-payments and underpayments. These entities are paid based on a percentage
of money they identify and collect on behalf of the government: - 🧠 ANSWER
✔✔Recovery Audit Contractors (RAC)
A patient is admitted for a diagnostic workup for cachexia. The final:diagnosis is
malignant neoplasm of lung with metastasis. The present on admission (POA)
indicator is - 🧠 ANSWER ✔✔Y = present at the time of inpatient admission
A patient undergoes outpatient surgery. During the recovery period, the patient
develops atrial fibrillation and is subsequently admitted to the hospital as an
inpatient. The present on admission (POA) indicator is" - 🧠 ANSWER ✔✔Y =
present at the time of inpatient admission
A patient was seen by Dr. Zachary. The charge for the office visit was $125. The
Medicare beneficiary had already met his deductible. The Medicare fee schedule
amount is $100. Dr. Zachary does not accept assignment. The office manager will
apply a practice termed as "balance billing" which means that the patient is: - 🧠
ANSWER ✔✔Financially liable for charges in excess of the Medicare fee
schedule, up to a limit
A patient with Medicare is seen in the physician's office. The total charge for this
office visit is $250.00. The patient has previously paid his deductible under
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
2
, Medicare Part B. The PAR Medicare fee schedule amount for this service is
$200.00. The non PAR Medicare fee schedule amount for this service is $190.00.
The patient is financially liable for the coinsurance amount, which is: - 🧠
ANSWER ✔✔20%
A patient with Medicare is seen in the physician's office. The total charge for this
office visit is $250.00. The patient has previously paid his deductible under
Medicare Part B. The PAR Medicare fee schedule amount for this service is
$200.00. The non PAR Medicare fee schedule amount for this service is $190.00: -
🧠 ANSWER ✔✔$200.00
A patient with Medicare is seen in the physician's office. The total charge for this
office visit is $250.00. The patient has previously paid his deductible under
Medicare Part B. The PAR Medicare fee schedule amount for this service is
$200.00. The non PAR Medicare fee schedule amount for this service is $190.00.
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
Questions Marking Scheme New Update
| A+ Rated
A HIPPS (Health Insurance Prospective Payment System) code is a five-character
alphanumeric code. A HIPPS code is used by: - 🧠 ANSWER ✔✔Home Health
Agencies (HHA)
and
Inpatient Rehabilitation Facilities (IRF)
A discharge in which the patient was discharged from the inpatient rehabilitation
facility and returned within three calendar days (prior to midnight on the third day)
is called a (n): - 🧠 ANSWER ✔✔Interrupted Stay
A fiscal year is a yearly accounting period. It is the 12-month period on which a
budget is planned. The federal fiscal year is: - 🧠 ANSWER ✔✔October 1st through
September 20th of the next year
A new initiative by the government to eliminate fraud and abuse and recover over-
payments involves the use of __________. Charts are audited to identify Medicare
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
1
,over-payments and underpayments. These entities are paid based on a percentage
of money they identify and collect on behalf of the government: - 🧠 ANSWER
✔✔Recovery Audit Contractors (RAC)
A patient is admitted for a diagnostic workup for cachexia. The final:diagnosis is
malignant neoplasm of lung with metastasis. The present on admission (POA)
indicator is - 🧠 ANSWER ✔✔Y = present at the time of inpatient admission
A patient undergoes outpatient surgery. During the recovery period, the patient
develops atrial fibrillation and is subsequently admitted to the hospital as an
inpatient. The present on admission (POA) indicator is" - 🧠 ANSWER ✔✔Y =
present at the time of inpatient admission
A patient was seen by Dr. Zachary. The charge for the office visit was $125. The
Medicare beneficiary had already met his deductible. The Medicare fee schedule
amount is $100. Dr. Zachary does not accept assignment. The office manager will
apply a practice termed as "balance billing" which means that the patient is: - 🧠
ANSWER ✔✔Financially liable for charges in excess of the Medicare fee
schedule, up to a limit
A patient with Medicare is seen in the physician's office. The total charge for this
office visit is $250.00. The patient has previously paid his deductible under
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
2
, Medicare Part B. The PAR Medicare fee schedule amount for this service is
$200.00. The non PAR Medicare fee schedule amount for this service is $190.00.
The patient is financially liable for the coinsurance amount, which is: - 🧠
ANSWER ✔✔20%
A patient with Medicare is seen in the physician's office. The total charge for this
office visit is $250.00. The patient has previously paid his deductible under
Medicare Part B. The PAR Medicare fee schedule amount for this service is
$200.00. The non PAR Medicare fee schedule amount for this service is $190.00: -
🧠 ANSWER ✔✔$200.00
A patient with Medicare is seen in the physician's office. The total charge for this
office visit is $250.00. The patient has previously paid his deductible under
Medicare Part B. The PAR Medicare fee schedule amount for this service is
$200.00. The non PAR Medicare fee schedule amount for this service is $190.00.
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
