Question 1

A patient was seen by Dr. Zachary. The charge for the office visit was $125. The Medicare beneficiary had already met his deductible. The Medicare fee schedule amount is $100. Dr. Zachary does not accept assignment. The office manager will apply a practice termed as "balance billing," which means that the patient is

Accepted Answer

A)  financially liable for the Medicare fee schedule amount. 
B)  financially liable for charges in excess of the Medicare fee schedule. 
C)  not financially liable for any amount. 
D)  is financially liable for the entire charge for the office visit.

Question 2

Juan has been asked to investigate e-health companies. Which of the following would NOT be included in his investigation?

Accepted Answer

A)  Health Data: a company that stores patient identifiable health information online 
B)  Health lnfo: a company that provides medical references to patients 
C)  Physician Services: a company that provides medical references to physicians 
D)  Cafe Services: a company that provides cafeteria services to the hospital

Question 3

Melissa is status post mastectomy due to breast cancer. There has been no recurrence of the disease. She is admitted for insertion of unilateral breast implant.

Accepted Answer

A)  V51.0, V10.3, 85.54 
B)  V58.42, V51.0, V45.71, V10.3, 85.53 
C)  V45.71, 174.9, 85.53 
D)  V51.0, V45.71, V10.3, 85.53

Question 4

A clerk brings you a question about a request for information. The patient was treated meningitis at age 3 (15 years ago). The patient is now 18. The patient's attorney is request information on the admission. You tell the clerk the information is

Accepted Answer

A)  no longer available because your facility retains information for 10 years after the last patient visit. 
B)  available, but the attorney will have to obtain a court order before you will release it. 
C)  available, but the patient's parents will have to sign a consent for you to release it. 
D)  available and the patient may sign a consent to release the information in the record.

Question 5

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

Accepted Answer

A)  home health resource groups (HHRGs). 
B)  case-mix groups (CMGs). 
C)  diagnosis-related groups (DRGs). 
D)  resource utilization groups (RUGs).

Question 6

Excision of 2.5 cm bladder tumor with cystoscopy.

Accepted Answer

A)  51550 
B)  51530 
C)  52235 
D)  51060

Question 7

In the diagnosis "first-, second-, and third-degree burns of the chest wall," a code is required for

Accepted Answer

A)  the first-degree burn only. 
B)  the second-degree burn only. 
C)  the third-degree burn only. 
D)  each first-, second-, and third-degree burn.

Question 8

The Blood Usage Review Committee has a quality monitor established to review all blood transfusion reaction cases. The HIM Director will be working with the committee to identify and abstract patient outcome information for committee evaluation. What data should be collected?

Accepted Answer

A)  effects of transfusion reaction (e.g., rash, death, etc.) 
B)  type and cross-match accuracy 
C)  justification for the transfusion 
D)  all of the above

Question 9

A run or line chart would be most useful for collecting data on

Accepted Answer

A)  waiting time in the Pediatrics Clinic. 
B)  patient satisfaction with the food. 
C)  Delays in scheduling elective surgical procedures. 
D)  Medication errors and their causes.

Question 10

Patient admitted for observation for head injury following a fall. Patient also suffered a minor laceration to the forehead. Head injury was ruled out.

Accepted Answer

A)  V71.4, 873.42, E888.9 
B)  873.42, E888.9 
C)  959.01, 873.42, E888.9 
D)  V71.4, E888.9

Question 11

Patient presents to the hospital for skin grafts due to previous third-degree burns. The burn' eschar of the back was removed. Once the eschar was removed, the defect size measured 10 an a, 10 cm. A skin graft from a donor bank was placed onto the defect and sewn into place as a temporary wound closure.

Accepted Answer

A)  15170,15002 
B)  15300 
C)  15002,15200 
D)  15002, 15300

Question 12

You are walking around the facility to identify any privacy and security issues. You walk onto the 6W nursing unit and stand in a public area to look for possible violations. From where you are standing, you see that anyone can watch the nurse entering confidential patient information. You make a note of this. What are you doing?

Accepted Answer

A)  conducting a gap analysis 
B)  conducting a risk assessment 
C)  monitoring audit trail 
D)  none of the above

Question 13

The physician explicitly documents that a condition is not present at the time of admission.

Accepted Answer

A)  Y=Yes 
B)  N=No 
C)  U=Unknown 
D)  W=clinically undetermined 
E)  Unreported/Not Used (Exempt from PO
A)  reporting

Question 14

A portion of a deficiency slip is reproduced below. This patient was discharged yesterday. Y greatest concern regarding deficiencies on this record would be the missing

Accepted Answer

A)  signature on the physical exam. 
B)  signature on the discharge summary. 
C)  diagnoses and procedures. 
D)  operative report.

Question 15

A local union is conducting .an organizing campaign at Pacific Health Systems. The Human Resources department is providing training to management staff. The training indicates that managers can do which of the following during the union campaign?

Accepted Answer

A)  state that a strike is inevitable if the union wins 
B)  promise regular wage increases 
C)  question employees about their union activity 
D)  state opposition to the union

Question 16

Patient presents to the emergency room following an assault. Examination of the patient reveals blunt trauma to the face. Radiology reports that the patient suffers from a fracture to the frontal skull and a blow-out fracture of the orbital floor. Patient is admitted and taken to the operating room where a periorbital approach to the orbital fracture is employed and an implant is inserted.

Accepted Answer

A)  21407; 21275 
B)  21387; 61330 
C)  21390 
D)  61340; 21401

Question 17

An accreditation agency counterpart to the Joint Commission for managed care organizations is the

Accepted Answer

A)  AHRQ. 
B)  AHCPR. 
C)  IOM. 
D)  NCQA.

Question 18

During systems analysis you use a tool that shows relations between data. You are using a(n)

Accepted Answer

A)  data dictionary. 
B)  data flow diagram. 
C)  flowchart. 
D)  entity relationship diagram.

Question 19

Patient suffered dizziness as a result of taking prescribed Phenobarbital. Patient took medication with beer.

Accepted Answer

A)  780.4, 980.0, E860.0 
B)  967.0, 980.0, 780.4, E851, E860.0 
C)  967.0, 708.4, E851 
D)  780.4, E851, E860.0

Question 20

Insertion of cochlear device innet ear

Accepted Answer

A)  69711 
B)  69949 
C)  69930 
D)  69960; 69990

Exam 1: Registered Health Information Administrator