RHIA

RHIA practice questions, page 66 of 73, with answer review and explanations.

Question 326

All of the following elements are found in the charge description master, EXCEPT for

  1. ICD-9-CM code.
  2. charge.
  3. HCPCS/CPT code.
  4. narrative description.

Question 327

Home health agencies are reimbursed on a prospective payment system (PPS) for Medicare patients. This PPS is called

  1. home health resource groups (HHRGs).
  2. case-mix groups (CMGs).
  3. diagnosis-related groups (DRGs).
  4. resource utilization groups (RUGs).

Question 328

These are assigned to every HCPCS/CPT code under the Medicare hospital outpatient prospective payment system to identify how the service or procedure described by the code would be paid.

  1. geographic practice cost indices
  2. major diagnostic categories
  3. minimum data set
  4. payment status indicator

Question 329

This means that the service or procedure is reasonable and necessary for the diagnosis or treatment of illness or injury consistent with generally accepted standards of care.

  1. peer review
  2. optimization
  3. benchmarking
  4. medical necessity

Question 330

The first step is -

  1. cases are differentiated based on the presence or absence of complications/comorbidites (CCs) or major complications/comorbidites (MCCs).
  2. cases are divided into either a surgical partition or a medical partition.
  3. the principal diagnosis determines the MDC assignment.
  4. diagnoses and procedures are coded using ICD-9-CM.