CDIP PRACTICE EXAM2 NEWEST EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
LATEST UPDATES 2025-2026 (100% CORRECT VERIFIED
ANSWERS) ALREADY GRADED A+
A database containing information and files submitted by fiscal intermediaries that is used by
the Office of the Inspector General to identify suspicious billing and charge practices
a.MEDPAR Medicare Provider Analysis and Review (MEDPAR) database system
b.ORYX
c.MS-DRG
d.PQRS - ANSWER-a-
MEDPAR Medicare Provider Analysis and Review (MEDPAR) data- base contains information
and files submitted by Medicare administrative contractors and utilized by OIG to identify
suspicious billing and charge practices (AHIMA 2014a, 24).
If a code does not agree with a code corresponding with the Medicare Code Edit table of
acceptable codes, it is considered
a.Duplicate
b.Invalid
c.Conflicting
d.Unacceptable - ANSWER-b-
,If a code does not agree with a code corresponding with the Medicare Code Edit table of
acceptable codes it is considered invalid and should be rejected (CMS Medicare Code Editor
2015).
Within the Medicare Code Editor, age conflict for maternity edits are:
a.10-55
b.15-60
c.12-55
d.16-60 - ANSWER-c-
The Medicare Code Editor lists the age of 12-55 as a maternity edit and should fail billing edits
(CMS Medicare Code Editor, 2015).
The codes for postoperative complications have been expanded and a distinction made
between intraoperative complications and what?
a.Other postop complications
b.Postprocedural disorders
c.Complications of trauma
d.Intraoperative lacerations - ANSWER-b-
The codes for postoperative complications have been expanded and a distinction made
between intraoperative complications and postprocedural disorders (Zeisset 2013, 35).
This system is currently being used in EHR systems as a clinical reference terminology to
capture data for problem lists and patient assessments at the point of care.
a.Problem-oriented record
b.CPT
c.SNOMED CT
d.DSM-V - ANSWER-c-
EHR systems are utilizing SNO-MED CT as a clinical reference terminology to capture data for
problem lists and patient assessments at the point of care. HHS recommended SNOMED CT as
,part of a core set of patient medical record information (PMRI) terminology in 2003 (Palkie
2013, 398).
On review of the audit trail for an EHR system, the HIM director discovers that a departmental
employee with authorized access to patient records is printing far more records than the
average user. In this case, what should the supervisor do?
a.Reprimand the employee.
b.Fire the employee.
c.Determine what information was printed and why.
d.Revoke the employee's access privileges. - ANSWER-c-
Audit trails are used to facilitate the determination of security violations and to identify areas
for improvement. Their usefulness is enhanced when they include trigger flags for automatic,
intensified review. In this case, the audit trail review should be used to begin an investigation
into what exactly the employee printed and why (Shaw and Carter 2014; LaTour et al. 2013,
101).
It has been brought to the attention of the compliance officer that codes are being rejected as
unacceptable principal diagnoses. Compliance should
a.Not worry about the problem
b.Ensure the coding is accurate
c.Follow up with the Medicare Administrative Contractor (MAC)
d.Both b and c - ANSWER-d-
Compliance should validate the coding is accurate follow with the MAC. It may also be
beneficial to obtain a policy related to the guidance (Leon-Chisen 2012).
Under CMS Program Integrity, one of the differences between a review and an audit is:
a.Audits occur every 30 days
b.Only contractors perform audits
c.Audits are methodological in their approach
d.There is no different - ANSWER-c-
, Reviews performed by contractors are usually flexible and broad ranged. Audits are
methodological and follow specific standards (CMS 2016d).
The coding director has some concerns related to the capture of encephalopathy. She plans to
take a closer look of coding, CDI, and code assignment. The director is performing a
a.A self-audit
b.A self-review
c.A risk assessment
d.Compliance review - ANSWER-a-
Within a given health care practice or business, providers perform a self-audit. This is an audit,
examination, review, or other inspection performed both by and facility. Self-audits generally
focus on assessing, correcting, and maintaining controls to promote compliance with applicable
laws, rules, and regulations (CMS 2016d).
A physician admits a patient with shortness of breath and chest pain, then treats the patient
with Lasix, oxygen, and Theophylline. The physician's final documented diagnosis for the patient
is acute exacerbation of COPD. What is missing from this diagnosis that would make it reliable
information in the treatment of this patient?
a.No additional information is needed.
b.The type of COPD
c.The reason the patient was treated with Lasix
d.The reason for the Theophylline - ANSWER-B-
If the physician does not document the diagnosis, the coding professional cannot assume the
patient has a diagnosis based solely on
a.An abnormal lab finding
b.Abnormal pathology reports
c.Both A and B
d.None of the above - ANSWER-c-
CORRECT DETAILED ANSWERS WITH RATIONALES
LATEST UPDATES 2025-2026 (100% CORRECT VERIFIED
ANSWERS) ALREADY GRADED A+
A database containing information and files submitted by fiscal intermediaries that is used by
the Office of the Inspector General to identify suspicious billing and charge practices
a.MEDPAR Medicare Provider Analysis and Review (MEDPAR) database system
b.ORYX
c.MS-DRG
d.PQRS - ANSWER-a-
MEDPAR Medicare Provider Analysis and Review (MEDPAR) data- base contains information
and files submitted by Medicare administrative contractors and utilized by OIG to identify
suspicious billing and charge practices (AHIMA 2014a, 24).
If a code does not agree with a code corresponding with the Medicare Code Edit table of
acceptable codes, it is considered
a.Duplicate
b.Invalid
c.Conflicting
d.Unacceptable - ANSWER-b-
,If a code does not agree with a code corresponding with the Medicare Code Edit table of
acceptable codes it is considered invalid and should be rejected (CMS Medicare Code Editor
2015).
Within the Medicare Code Editor, age conflict for maternity edits are:
a.10-55
b.15-60
c.12-55
d.16-60 - ANSWER-c-
The Medicare Code Editor lists the age of 12-55 as a maternity edit and should fail billing edits
(CMS Medicare Code Editor, 2015).
The codes for postoperative complications have been expanded and a distinction made
between intraoperative complications and what?
a.Other postop complications
b.Postprocedural disorders
c.Complications of trauma
d.Intraoperative lacerations - ANSWER-b-
The codes for postoperative complications have been expanded and a distinction made
between intraoperative complications and postprocedural disorders (Zeisset 2013, 35).
This system is currently being used in EHR systems as a clinical reference terminology to
capture data for problem lists and patient assessments at the point of care.
a.Problem-oriented record
b.CPT
c.SNOMED CT
d.DSM-V - ANSWER-c-
EHR systems are utilizing SNO-MED CT as a clinical reference terminology to capture data for
problem lists and patient assessments at the point of care. HHS recommended SNOMED CT as
,part of a core set of patient medical record information (PMRI) terminology in 2003 (Palkie
2013, 398).
On review of the audit trail for an EHR system, the HIM director discovers that a departmental
employee with authorized access to patient records is printing far more records than the
average user. In this case, what should the supervisor do?
a.Reprimand the employee.
b.Fire the employee.
c.Determine what information was printed and why.
d.Revoke the employee's access privileges. - ANSWER-c-
Audit trails are used to facilitate the determination of security violations and to identify areas
for improvement. Their usefulness is enhanced when they include trigger flags for automatic,
intensified review. In this case, the audit trail review should be used to begin an investigation
into what exactly the employee printed and why (Shaw and Carter 2014; LaTour et al. 2013,
101).
It has been brought to the attention of the compliance officer that codes are being rejected as
unacceptable principal diagnoses. Compliance should
a.Not worry about the problem
b.Ensure the coding is accurate
c.Follow up with the Medicare Administrative Contractor (MAC)
d.Both b and c - ANSWER-d-
Compliance should validate the coding is accurate follow with the MAC. It may also be
beneficial to obtain a policy related to the guidance (Leon-Chisen 2012).
Under CMS Program Integrity, one of the differences between a review and an audit is:
a.Audits occur every 30 days
b.Only contractors perform audits
c.Audits are methodological in their approach
d.There is no different - ANSWER-c-
, Reviews performed by contractors are usually flexible and broad ranged. Audits are
methodological and follow specific standards (CMS 2016d).
The coding director has some concerns related to the capture of encephalopathy. She plans to
take a closer look of coding, CDI, and code assignment. The director is performing a
a.A self-audit
b.A self-review
c.A risk assessment
d.Compliance review - ANSWER-a-
Within a given health care practice or business, providers perform a self-audit. This is an audit,
examination, review, or other inspection performed both by and facility. Self-audits generally
focus on assessing, correcting, and maintaining controls to promote compliance with applicable
laws, rules, and regulations (CMS 2016d).
A physician admits a patient with shortness of breath and chest pain, then treats the patient
with Lasix, oxygen, and Theophylline. The physician's final documented diagnosis for the patient
is acute exacerbation of COPD. What is missing from this diagnosis that would make it reliable
information in the treatment of this patient?
a.No additional information is needed.
b.The type of COPD
c.The reason the patient was treated with Lasix
d.The reason for the Theophylline - ANSWER-B-
If the physician does not document the diagnosis, the coding professional cannot assume the
patient has a diagnosis based solely on
a.An abnormal lab finding
b.Abnormal pathology reports
c.Both A and B
d.None of the above - ANSWER-c-
