AHIMA AHIMA Certifications RHIA Questions & Answers

• Question 1431:

  To monitor timely claims processing in a hospital, a summary report of "patient receivables" is generated frequently. Aged receivables can negatively affect a facility's cash flow; therefore, to maintain the facility's fiscal integrity, the HIM manager must routinely analyze this report.

  A. remittance advice

  B. periodic interim payments

  C. DNFB (discharged, no final bill)

  D. chargemaster

  Correct Answer: C

• Question 1432:

  When appropriate, under the outpatient PPS, a hospital can use this CPT code in place of, but not in addition to, a code for a medical visit or emergency department service.

  A. CPT Code 99291 (critical care)

  B. CPT Code 99358 (prolonged evaluation and management service)

  C. CPT Code 35001 (direct repair of aneurysm)

  D. CPT Code 50300 (donor nephrectomy)

  Correct Answer: A

• Question 1433:

  This is the difference between what is charged and what is paid.

  A. costs

  B. charges

  C. reimbursement

  D. contractual allowance

  Correct Answer: D

• Question 1434:

  This is the amount the facility actually bills for the services it provides.

  A. costs

  B. charge accounting

  C. reimbursement

  D. contractual allowance

  Correct Answer: B

• Question 1435:

  This accounting method attributes a dollar figure to every input required to provide a service.

  A. cost accounting

  B. charge accounting

  C. reimbursement

  D. contractual allowance

  Correct Answer: A

• Question 1436:

  Assume the patient has already met his or her deductible and that the physician is a Medicare participating (PAR) provider. The physician's standard fee for the services provider is $120.00. Medicare's PAR fee is $60.00. How much reimbursement will the physician receive from Medicare?

  A. $ 120.00

  B. $ 60.00

  C. $ 48.00

  D. $ 96.00

  Correct Answer: C

• Question 1437:

  This is the amount collected by the facility for the services it bills.

  A. costs

  B. charges

  C. reimbursement

  D. contractual allowance

  Correct Answer: C

• Question 1438:

  This information is published by the Medicare contractors to describe when and under what circumstances Medicare will cover a services. The ICD-9-CM and CPT/HCPCS codes are listed in the memoranda.

  A. LCD (Local Coverage Determinations)

  B. CCI (Correct Coding Initiatives)

  C. OSHA (Occupational Safety and Health Administration)

  D. PEPP (Payment Error Prevention Program)

  Correct Answer: A

• Question 1439:

  The term "hard coding" refers to

  A. HCPCS/CPT codes that are coded by the coders.

  B. HPCS/CPT codes that appear in the hospital's chargemaster and will be included automatically on the patient's bill.

  C. ICD-9-CM codes that are coded by the coders.

  D. ICD-9-CM codes that appear in the appear in the hospital's chargemaster

  Correct Answer: B

• Question 1440:

  This prospective payment system is for ______________ and utilizes a patient assessment instrument (PAI) to classify patients into case-mix groups (CMGs).

  A. skilled nursing facilities

  B. inpatient rehabilitation facilities

  C. home health agencies

  D. long-term acute care hospitals

  Correct Answer: B