Actual Exam Questions and CORRECT
Answers
Mary Smith, RHIA, has been charged with the responsibility of designing a data collection
form to be used on admission of a patient to the acute-care hospital in which she works. The
first resource that she should use is:
UHDDS
UACDS
MDS
ORYX - CORRECT ANSWER- ✔✔a
When the CCI editor flags that a comprehensive code and a component code are billed
together for the same beneficiary on the same date of service, Medicare will pay for:
The component code but not the comprehensive code
The comprehensive but not the component code
The comprehensive and the component codes
Neither the comprehensive nor the component codes - CORRECT ANSWER- ✔✔b
When clean claims are submitted, they can be adjudicated in many ways through computer
software automatically. Which statement is not one of the outcomes that can occur as part of
auto-adjudication?
Auto-pay
,Auto-suspend
Auto-calculate
Auto-deny - CORRECT ANSWER- ✔✔c
Which of the following is not a way that ICD-10-CM improves coding accuracy?
Reduces sequencing problems by combining conditions into one code
Provides laterality options
Captures more details for injuries, diabetes, and postoperative complications
Increases cross-referencing - CORRECT ANSWER- ✔✔d
Which of the following organizations is responsible for updating the procedure classification
of ICD-10-PCS?
Centers for Disease Control (CDC)
Centers for Medicare and Medicaid Services (CMS)
National Center for Health Statistics (NCHS)
World Health Organization (WHO) - CORRECT ANSWER- ✔✔b
This program was initiated by the Balanced Budget Act of 1997 and allows states to expand
existing insurance programs to cover children up to age 19.
Children's State Medicare Program (CSMP)
State Children's Health Insurance Program (SCHIP)
,Children's State Healthcare Alliance (CSHA)
Children's Aid to Healthcare (CAH) - CORRECT ANSWER- ✔✔b
Which of the following provides a complete description to patients about how PHI is used in
a healthcare facility?
Notice of Privacy Practices
Authorization
Consent for treatment
Minimum necessary - CORRECT ANSWER- ✔✔a
The National Correct Coding Initiative was developed to control improper coding leading to
inappropriate payment for:
Part A Medicare claims
Part B Medicare claims
Medicaid claims
Medicare and Medicaid claims - CORRECT ANSWER- ✔✔b
The National Correct Coding Initiative was developed to control improper coding leading to
inappropriate payment for:
Part A Medicare claims
Part B Medicare claims
Medicaid claims
, Medicare and Medicaid claims - CORRECT ANSWER- ✔✔b
Which of the following software applications would be used to aid in the coding function in a
physician's office?
Grouper
Encoder
Pricer
Diagnosis calculator - CORRECT ANSWER- ✔✔b
What is the maximum number of diagnosis codes that can appear on the UB-04 paper claim
form locator 67 for a hospital inpatient principal and secondary diagnoses?
35
25
18
9 - CORRECT ANSWER- ✔✔b
CMS identified conditions that are not present on admission and could be "reasonably
preventable." Hospitals are not allowed to receive additional payment for these conditions
when the condition is present on admission. What are these conditions called?
Conditions of Participation
Present on admission
Hospital-acquired conditions