AHIMA RHIT TEST PAPER 2025/2026 QUESTIONS AND
SOLUTION RATED A+
✔✔A patient has a malunion of an intertrochanteric fracture of the right hip, which is
treated with a proximal femoral osteotomy by incision. What is the correct ICD-10-PCS
code for this procedure?
a. 0QB60ZZ
b. 0Q860ZZ
c. 0SB90ZZ
d. 0SN90ZZ - ✔✔b. 0Q860ZZ
Medical and Surgical—0
Body System is Lower Bones—Q
Root Operation is Division—8
Body Part is Femur, Right—6
Approach is Open—0
No Device—Z
No Qualifier —Z
✔✔A hospital can monitor its performance under the MS-DRG system by monitoring its:
a. Accounts receivable
b. Operating costs
c. RBRVS payments
d. Case-mix index - ✔✔d. Case-mix index
✔✔Which of the following could be a focus of a coding quality review program?
a. CC and MCC coding rates (MS-DRGs)
b. Outpatient Code Editor failure rates
c. Coding completed by new coders
d. New coding guidelines - ✔✔c. Coding completed by new coders
✔✔What practice do HIM departments use to protect themselves from RAC identifying
coding and billing errors?
a. Prebilling coding audits
b. Postbilling coding audits
c. Complex reviews
d. Semi-automated reviews - ✔✔a. Prebilling coding audits
✔✔Carolyn works as an inpatient coder in a hospital HIM department. She views 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?
,a. Assign a code for the staph infection
b. Put a note in the chart
c. Query the physician
d. Tell her supervisor - ✔✔c. Query the physician
✔✔A patient who has been diagnosed with hypertension visits her physician on a
monthly basis. The nurse conducted the blood pressure check under the physician's
supervision. Code the office visit.
a. 99211, Office or other outpatient visit of the evaluation and management of an
established patient that may not require the presence of a physician or other qualified
health care professional.
b. 99201, Office or other outpatient visit for the evaluation and management of a new
patient, which requires these three key components: problem focused history and
examination, straightforward medical decision.
c. 99203, Office or other outpatient visit for the evaluation and management of a new
patient, which requires these three key components: detailed history and examination,
low complexity medical decision.
d. 99212, Office or other outpatient visit for the evaluation and management of an
established patient, which requires a - ✔✔a. 99211, Office or other outpatient visit of the
evaluation and management of an established patient that may not require the presence
of a physician or other qualified health care professional.
✔✔A patient is admitted with a history of prostate cancer and with mental confusion.
The patient completed radiation therapy for prostate carcinoma three years ago and is
status post a radical resection of the prostate. A CT scan of the brain during the current
admission reveals metastasis. Which of the following is the correct coding and
sequencing for the current hospital stay?
a. Metastatic carcinoma of the brain; carcinoma of the prostate; mental confusion
b. Mental confusion; history of carcinoma of the prostate; admission for chemotherapy
c. Metastatic carcinoma of the brain; history of carcinoma of the prostate
d. Carcinoma of the prostate; metastatic carcinoma to the brain - ✔✔c. Metastatic
carcinoma of the brain; history of carcinoma of the prostate
✔✔The ICD-10-CM utilizes a placeholder character at certain codes to allow for future
expansion of the classification system. What letter is used to represent this placeholder
character?
a. A
b. G
c. U
d. X - ✔✔d. X
, ✔✔The period of time between discharge and claim submission, which a facility defines
by policy, is called the:
a. AR days
b. Bill hold
c. Cash flow days
d. Denial period - ✔✔b. Bill hold
✔✔Medicare inpatient reimbursement levels are based on:
a. CPT codes reported during the encounter
b. MS-DRG calculated for the encounter
c. Charges accumulated during the episode of care
d. Usual and customary charges reported during the encounter - ✔✔b. MS-DRG
calculated for the encounter
✔✔When the physician does not specify the method used to remove a lesion during an
endoscopy, what is the appropriate procedure?
a. Assign the removal by snare technique code
b. Assign the removal by hot biopsy forceps code
c. Assign the ablation code
d. Query the physician as to the method used - ✔✔d. Query the physician as to the
method used
✔✔Identify the two-digit modifier that may be reported to indicate a physician performed
the postoperative management of a patient but another physician performed the
surgical procedure.
a. −22, Increased procedural services
b. −54, Surgical care only
c. −32, Mandated service
d. −55, Postoperative management only - ✔✔d. −55, Postoperative management only
✔✔A newborn is treated for pulmonary valve stenosis, with stretching of the valve
opening accomplished via a percutaneous balloon pulmonary valvuloplasty. In ICD-10-
PCS, what root operation would be coded for this procedure?
a. Alteration
b. Dilation
c. Repair
d. Restriction - ✔✔b. Dilation
✔✔The practice of using a code that results in a higher payment to the provider than the
code that actually reflects the service or item provided is known as:
SOLUTION RATED A+
✔✔A patient has a malunion of an intertrochanteric fracture of the right hip, which is
treated with a proximal femoral osteotomy by incision. What is the correct ICD-10-PCS
code for this procedure?
a. 0QB60ZZ
b. 0Q860ZZ
c. 0SB90ZZ
d. 0SN90ZZ - ✔✔b. 0Q860ZZ
Medical and Surgical—0
Body System is Lower Bones—Q
Root Operation is Division—8
Body Part is Femur, Right—6
Approach is Open—0
No Device—Z
No Qualifier —Z
✔✔A hospital can monitor its performance under the MS-DRG system by monitoring its:
a. Accounts receivable
b. Operating costs
c. RBRVS payments
d. Case-mix index - ✔✔d. Case-mix index
✔✔Which of the following could be a focus of a coding quality review program?
a. CC and MCC coding rates (MS-DRGs)
b. Outpatient Code Editor failure rates
c. Coding completed by new coders
d. New coding guidelines - ✔✔c. Coding completed by new coders
✔✔What practice do HIM departments use to protect themselves from RAC identifying
coding and billing errors?
a. Prebilling coding audits
b. Postbilling coding audits
c. Complex reviews
d. Semi-automated reviews - ✔✔a. Prebilling coding audits
✔✔Carolyn works as an inpatient coder in a hospital HIM department. She views 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?
,a. Assign a code for the staph infection
b. Put a note in the chart
c. Query the physician
d. Tell her supervisor - ✔✔c. Query the physician
✔✔A patient who has been diagnosed with hypertension visits her physician on a
monthly basis. The nurse conducted the blood pressure check under the physician's
supervision. Code the office visit.
a. 99211, Office or other outpatient visit of the evaluation and management of an
established patient that may not require the presence of a physician or other qualified
health care professional.
b. 99201, Office or other outpatient visit for the evaluation and management of a new
patient, which requires these three key components: problem focused history and
examination, straightforward medical decision.
c. 99203, Office or other outpatient visit for the evaluation and management of a new
patient, which requires these three key components: detailed history and examination,
low complexity medical decision.
d. 99212, Office or other outpatient visit for the evaluation and management of an
established patient, which requires a - ✔✔a. 99211, Office or other outpatient visit of the
evaluation and management of an established patient that may not require the presence
of a physician or other qualified health care professional.
✔✔A patient is admitted with a history of prostate cancer and with mental confusion.
The patient completed radiation therapy for prostate carcinoma three years ago and is
status post a radical resection of the prostate. A CT scan of the brain during the current
admission reveals metastasis. Which of the following is the correct coding and
sequencing for the current hospital stay?
a. Metastatic carcinoma of the brain; carcinoma of the prostate; mental confusion
b. Mental confusion; history of carcinoma of the prostate; admission for chemotherapy
c. Metastatic carcinoma of the brain; history of carcinoma of the prostate
d. Carcinoma of the prostate; metastatic carcinoma to the brain - ✔✔c. Metastatic
carcinoma of the brain; history of carcinoma of the prostate
✔✔The ICD-10-CM utilizes a placeholder character at certain codes to allow for future
expansion of the classification system. What letter is used to represent this placeholder
character?
a. A
b. G
c. U
d. X - ✔✔d. X
, ✔✔The period of time between discharge and claim submission, which a facility defines
by policy, is called the:
a. AR days
b. Bill hold
c. Cash flow days
d. Denial period - ✔✔b. Bill hold
✔✔Medicare inpatient reimbursement levels are based on:
a. CPT codes reported during the encounter
b. MS-DRG calculated for the encounter
c. Charges accumulated during the episode of care
d. Usual and customary charges reported during the encounter - ✔✔b. MS-DRG
calculated for the encounter
✔✔When the physician does not specify the method used to remove a lesion during an
endoscopy, what is the appropriate procedure?
a. Assign the removal by snare technique code
b. Assign the removal by hot biopsy forceps code
c. Assign the ablation code
d. Query the physician as to the method used - ✔✔d. Query the physician as to the
method used
✔✔Identify the two-digit modifier that may be reported to indicate a physician performed
the postoperative management of a patient but another physician performed the
surgical procedure.
a. −22, Increased procedural services
b. −54, Surgical care only
c. −32, Mandated service
d. −55, Postoperative management only - ✔✔d. −55, Postoperative management only
✔✔A newborn is treated for pulmonary valve stenosis, with stretching of the valve
opening accomplished via a percutaneous balloon pulmonary valvuloplasty. In ICD-10-
PCS, what root operation would be coded for this procedure?
a. Alteration
b. Dilation
c. Repair
d. Restriction - ✔✔b. Dilation
✔✔The practice of using a code that results in a higher payment to the provider than the
code that actually reflects the service or item provided is known as:
