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Exam (elaborations)

RHIA Domain 4 Study Test Questions with Answers

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  • RHIA Domain 4

RHIA Domain 4 Study Test Questions with Answers A CDI program facilitates accurate coding & helps coders avoid: A. NCCI edits B. Upcoding C. Coding without a complete face sheet D. Assumption coding - Answer-D. Assumption coding Which of the following is a governmental designation by t...

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  • August 17, 2024
  • 5
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • RHIA Domain 4
  • RHIA Domain 4
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Scholarsstudyguide
RHIA Domain 4 Study Test Questions
with Answers
A CDI program facilitates accurate coding & helps coders avoid:

A. NCCI edits
B. Upcoding
C. Coding without a complete face sheet
D. Assumption coding - Answer-D. Assumption coding

Which of the following is a governmental designation by the state that is necessary for
the facility to offer services?

A. Survey
B. Licensure
C. Certification
D. Accreditation - Answer-B.
Licensure

Reviewing claims to ensure appropriate coding for deserved payments is one method
of:

A. Achieving legitimate optimization
B. Improving documentation
C. Ensuring compliance
D. Using data monitors - Answer-A. Achieving legitimate optimization

Which of the following is an example of internal medical identity theft?
A. Sue in her role as a patient registration clerk uses a patient's insurance info to see a
specialist for cosmetic surgery.
B. Joe uses a patient's info obtained through hacking the healthcare facility system.
C. Joan, an ICU nurse accesses the record of the patient she's currently treating.
D. Bob introduces a virus into the facility's health info system. - Answer-A. Sue in her
role as a patient registration clerk uses a patient's insurance info to see a specialist for
cosmetic surgery.

It's the year 201X. The federal gov't is determined to lower the overall payments to
physicians. To incur the least admin work, which of the following elements of the
physician payment system would the gov't reduce?
A. Conversion factor
B. RVU
C. GPCI
D. Weighted discount - Answer-A. Conversion factor

, A Joint Commission accredited organization must review their formulary annually to
ensure a medication's continued:
A. Safety and dose
B. Efficiency and efficacy
C. Efficacy and safety
D. Dose and efficency - Answer-C. Efficacy and safety

Part of the coding supervisor's responsibility is to review accounts that haven't been
final billed due to errors. One of the accounts on the list is a same-day procedure. Upon
review, the coding supervisor notices the charge code on the bill was hard-coded. The
ambulatory procedure coder added the same CPT code to the abstract. How should this
error be corrected?
A. Delete the code from the CDM because it shouldn't be there.
B. Refer the case to the chargemaster coordinator
C. Force a final bill on the accounts since the duplication won't affect the UB-04
D. Remove the code from the abstract and counsel the coder regarding CDM hard
codes in this service - Answer-D. Remove the code from the abstract and counsel the
coder regarding CDM hard codes in this service


Which of the following statements about new technology items included on the charge
description master (CDM) is false?

A. The CDM maintenance committee should review new technology items for FDA
approval.
B. The CDM maintenance committee should review new technology items for OPPS
pass-through assignment.
C. The CDM maintenance committee should have a professional coder review code
assignments even if codes are suggested by the manufacturer.
D. The codes for new technology should not be included in the CDM until coverage has
been determined. - Answer-D. The codes for new technology should not be included in
the CDM until coverage has been determined.

Patient accounting is reporting an increase in national coverage decisions (NCDs), and
local coverage determinations (LCDs) failed edits in observation accounts. Which of the
following departments will be tasked to resolve this issue?

A. Utilization management
B. Patient access
C. HIM
D. Patient accounts - Answer-C. HIM

The discharged, not final billed report (also known as discharged, no final bill or
accounts not selected for billing or DNFB) includes what type of accounts?

A. Accounts that have been discharged and not billed for a variety of reasons

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