AHIMA AHIMA Certifications RHIA Questions & Answers

• Question 1441:

  Home health agencies (HHAs) utilize a data entry software system developed by the Centers for Medicare and Medicaid Services (CMS). This software is available to HHAs at no cost through the CMS Web site or on a CD-ROM.

  A. PACE (Patient Assessment and Comprehensive Evaluation)

  B. HAVEN (Home Assessment Validation and Entry)

  C. HHASS (Home Health Agency Software System)

  D. PEPP (Payment Error Prevention Program)

  Correct Answer: B

• Question 1442:

  Under the APC methodology, discounted payments occur when

  A. there are two or more (multiple) procedures that are assigned to status indicator "T."

  B. there are two or more (multiple) procedures that are assigned to status indicator "S."

  C. modifier ?3 is used to indicate a procedure is terminated after the patient is prepared, but before anesthesia is started.

  D. Both A and C

  Correct Answer: D

• Question 1443:

  To compute the reimbursement to a particular hospital for a particular MS-DRG, multiply the hospital's base payment rate by the

  A. conversion factor.

  B. case-mix index.

  C. geographic price index.

  D. relative weight for the MS-DRG.

  Correct Answer: D

• Question 1444:

  Once all data are posted to a patient's account, the claim can be reviewed for accuracy and completeness. Many facilities have internal auditing systems. The auditing systems run each claim through a set of edits specifically designed for the various third-party payers. The auditing system identifies data that have failed edits and flags the claim for correction. These "internal" auditing systems are called

  A. scrubbers.

  B. outliers.

  C. groupers.

  D. encoders.

  Correct Answer: A

• Question 1445:

  The term used to describe a diagram depicting grouper logic in assigning MS-DRGs is

  A. blended chart.

  B. case-mix index.

  C. decision tree.

  D. grouper hierarchy.

  Correct Answer: C

• Question 1446:

  Under Medicare, a beneficiary has lifetime reserve days. All of the following statements are true, EXCEPT

  A. the patient has a total of 60 lifetime reserve days.

  B. lifetime reserve days are usually reserved for use during the patient's final terminal hospital stay.

  C. lifetime reserve days are paid under Medicare Part B.

  D. lifetime reserve days are not renewable, meaning once a patient uses all of their lifetime reserve days, the patient is responsible for the total charges.

  Correct Answer: C

• Question 1447:

  under Medicare Part B, all of the following statements are true and are applicable to nonparticipating physician providers, EXCEPT

  A. providers must file all Medicare claims.

  B. nonparticipating providers have a higher fee schedule than that for participating providers.

  C. fees are restricted to charging no more than the "limiting charge" on nonassigned claims.

  D. collections are restricted to only the deductible and coinsurance due at the time of service on an assigned claim.

  Correct Answer: B

• Question 1448:

  In employer-sponsored health plans, employees may select their health plan.

  A. during the contract period.

  B. at the beginning of each fiscal year.

  C. during the open enrollment period.

  D. on the first day of any month.

  Correct Answer: C

• Question 1449:

  Which modifier indicates that a signed ABN is on file?

  A. AB

  B. GA

  C. GY

  D. GZ

  Correct Answer: B

• Question 1450:

  The following coding system(s) is/are utilized in the Impatient Psychiatric Facilities (IPFs) prospective payment methodology for assignment and proper reimbursement.

  A. HCPCS/CPT codes

  B. ICD-9-CM codes

  C. both HCPCS/CPT codes and ICD-9-CM codes

  D. none of the above

  Correct Answer: B