AHIMA AHIMA Certifications RHIA Questions & Answers

• Question 1481:

  The Correct Coding Initiative (CCI) edits contain a listing of codes under two columns titled, "comprehensive codes" and "component codes." According to the CCI edits, when a provider bills Medicare for a procedure that appears in both columns for the same beneficiary on the same date of service.

  A. code only the component code.

  B. do not code either one.

  C. code only the comprehensive code.

  D. code both the comprehensive code and the component code.

  Correct Answer: C

• Question 1482:

  The hospital outpatient prospective payment system for Medicare applies to all of the following EXCEPT.

  A. professional services, such as physician fees.

  B. facility reimbursement for outpatient hospital clinic visits.

  C. facility reimbursement for emergency department visits.

  D. facility reimbursement for hospital-based ambulatory surgery.

  Correct Answer: A

• Question 1483:

  A Medicare patient has arthroscopic analysis of adhesions and shaving of the particular

  

  The Medicare CCI (Correct Coding Initiative) edits indicate that code 29877 is not a component code for 29884, but code 29884 is a component code for 29877. The correct code(s) to be reported on this claim is (are)

  A. 29884-RT and 29877-RT.

  B. 29884-RT.

  C. 29877-RT.

  D. neither code.

  Correct Answer: C

• Question 1484:

  this prospective payment system replaced the Medicare physician payment system of "customary, prevailing, and reasonable (CPR)" charges whereby physicians were reimbursed according to historical record of the charge for the provision of each service.

  A. Medicare Physician Fee Schedule (MPFS)

  B. Medicare Severity Diagnosis Related Groups (MS-DRGs)

  C. Medicare Case Mix Index

  D. MEDISGRPS

  Correct Answer: A

• Question 1485:

  Changes in case mix index (CMI) may be attributed to all of the following factors EXCEPT

  A. changes in medical staff composition

  B. changes in coding rules

  C. changes in services offered

  D. changes in coding productivity

  Correct Answer: D

• Question 1486:

  In a global payment methodology which is sometimes applied to radiological and similar types of procedures that involve professional and technical components, all of the following are part of the "technical components EXCEPT

  A. radiological equipment.

  B. physician services.

  C. radiological supplies.

  D. support services.

  Correct Answer: B

• Question 1487:

  A discharge in which the patient was discharged from the inpatient rehabilitation facility and returned within 3 calendar days is called a(n)

  A. interrupted stay.

  B. transfer.

  C. per diem.

  D. qualified discharge.

  Correct Answer: A

• Question 1488:

  Under the outpatient prospective payment system (OPPS), status indicator "______" is a payment indicator that refers to "significant procedures for which the multiple procedure reduction applies." This means that the reported CPT and/or HCPCS Level II code will be paid a discounted APC reimbursement rate when reported with other procedures on the same claim.

  A. "T"

  B. "X"

  C. "S"

  D. "A"

  Correct Answer: C

• Question 1489:

  Under the inpatient prospective payment system (IPPS), there is a three-day payment window (formerly referred to as the 72-hour rule). This rule requires that outpatient preadmission services that are provided by a hospital up to three calendar days prior to a patient's inpatient admission be covered by the IPPS MSDRG payment for

  A. diagnostic services.

  B. therapeutic (or non-diagnostic) services whereby the inpatient principal diagnosis code (ICD-9-CM) exactly matches the code used for pre-admission services.

  C. therapeutic (or non-diagnostic) services whereby the inpatient principal diagnosis code (ICD-9-CM) does not match the code used for pre-admission services.

  D. both A and B.

  Correct Answer: D

• Question 1490:

  If the Medicare nonPAR approved payment amount is $128.00 for a proctoscopy, what is the total Medicare approved payment amount for a doctor who does not accept assignment, applying the limiting charge for this procedure?

  A. $ 140.80

  B. $ 143.00

  C. $ 192.00

  D. $ 147.20

  Correct Answer: D