Study Study Study
Greg is a recent graduate who has applied for a Trauma Registry position at a Chicago hospital while he prepared to apply to graduate school. In maligning the decision, he considered the offer of $15 per hour for a 40 hour week, benefits of 27.5% of his salary, and tuition waivers of 6 credits per year of $145. He calculated that his total compensation, rounded to the nearest dollar would be
$40,650
If a hospitals payment rate is $5,000, what payment would a hospital expect to receive for a patient treated for heart failure and shock and assigned to MS-DRG 292, Heart Failure and Shock with a relative weight of 1.0069?
$5034
As the Director of the Health Information Department, you are preparing a request for approval for the purchase of an encoder system. Bc this is considered a capital request, you are required to submit the cost-benefit ratio. The software and license cost $6,000, hardware maintenance is $1,500, and the training of 2 employees will cost $500. It is expected that the encoding system will increase reimbursement by $10,000. The Cost- benefit ratio is
1.25
Which one of the following represents the best or most positive average age of accounts receivable?
10 days
A patient presented to the physician's office for removal of 10 skin tags on his torso. During the procedure, the patient became anxious and the procedure was discontinued. No skin tags were removed. Which code is reported?
11200-53
The coder works 7.5 hours per day. If a time standard is determined from sample observations to be 2.50 minutes per record for coding emergency room records, what is the daily standard for the number of records coded when a 15% fatigue factor is allowed?
153 records per day.
A hospital reports the following statistics for the past year: Births, 1345; deliveries, 1340; C sections, 60; and obstetrical discharges, 1425. The C-section rate for that year is
4.48%
Listed below are the findings from a recent coding audit 50 records reviewed 15 coding errors were identified with an average of 2 per record a total of 250 codes were reviewed Calculate the coding accuracy rate using the code-over-code method
94%
Which one of the following agencies certifies levels I, II, III, & IV trauma centers?
American College of Surgeons
Identifying user information needs is part of the ______________________ phase of the systems development life cycle.
Analysis
The fifth character in a PCS code represents the
Approach the physician took to accomplish the procedure
24 year-old-female was admitted due to fever of 102 and chills. She has frequent UTIS. the uti culture was negative. She is started on IV ciprofloxacin and aminoglycoside for a period of 72 hours. after which she improved. Final diagnosis was "Possible urinary tract infection". Which one of the following describes the action a coder should take when coding this admission?
Assign the code for a UTI
You sit on the quality improvement team for the Nursing department that meets to generate ideas to address verbal order documentation problems about the "Read Back Verbal Order" policy. What QI tool would prove useful in sharing input and various recommendations for solving this problem?
Brainstorming
Skilled nursing facilities may choose to submit MDS data using RAVEN software, or software purchased commercially through a vendor, provided that the software meets
CMS Standards
A group of researcher wanted to determine the pre-accident risk factors of white males who were paralyzed in diving accidents. Which research design should the researchers use?
Case-control study
Changes in case-mix index(CMI) may be attributed to all of the following factors EXCEPT
Changes in coding productivity
A patient is admitted to the ambulatory care unit of the hospital for a planned cholecystectomy because she has cholelithiasis. Shortly before surgery, she developed tachycardia and elevated blood pressure, and the surgery was cancelled. After a workup for the unit. This outpatient admission should have which diagnosis code sequenced first?
Cholelithiasis
This is the difference between what is charged and what is paid.
Contractual allowance
Suppose a hospital system has admitted to fraudulent billing practices and has agreed to the settlement offered by the Office of Inspector General (OIG). The hospital will be obligated to follow a compliance program which involves substantial government oversight in the hospital compliance activities. The hospital is under a
Corporate Integrity Agreement
Which of the following is the statistic that would be used to explore the relationship between length of stay and patient age?
Correlation
We are updating our Master Patient Index to reflect a change in a patient's allergies. This would ensure which element of data quality
Data accuracy
Setting a standard for data capture, such as identifying the pattern for date of birth (DDMMYY or DDMMYYYY) and determining the number of possible characters per data field is described in a
Data dictionary
You want to depict the movement of patient information from the time of admittance to the point of discharge. Which of the following tools is most appropriate?
Data flow diagram
A person against whom an action is brought in a lawsuit is the
Defendant
Which registry would likely contain the lab value "HbA1c"?
Diabetes registries
What is the other term used to denote contingency planning required by HIPAA?
Disaster recovery planning
You are interviewing a candidate for a subpoena clerk position in the ROI section. Which of the following is the least appropriate information to ask an interviewee to provide?
Do you have family responsibilities that would keep you from remaining at a trial?
What form of logical topology is most widely used today for local area networks?
Ethernet
At an academic health center, a patient is subject in a randomized controlled trial involving 325 subjects. The patients pre-treatment laboratory tests have been recorded. The patient has been scheduled for a post-treatment follow up during which laboratory finding will again be recorded. Unknown to both the patient and her physician, the patient is in the control group. In what type of research study is this patient participating?
Experimental
Tables and charts represent a symbolic representation of data.
False
The CFO of your facility asks you to prepare a budget for the fiscal year based on the past volume and expected capacity for the coming year. This process is an example of using the __________________ budgeting method.
Fixed budget
Your HIM department is moving to a new location and in order to arrange your employees and functions for optimal work flow efficiency and to decide which employees need to be placed close to each other, the tool you decide to use is a
Flow process chart
Data mappings are sets of relationships established between two vocabularies in order to allow automated translation or connection between them. A map between ICD-9-CM to ICD-10-CM would be considered a
Forward Map
A patient is admitted for repair of a fracture of the hip following a fall down stairs. She delivered a baby 2 weeks ago.While she was hospitalized for the fracture, she developed a postpartum pulmonary embolism. She responded well to treatment for the embolism and the hip surgery and was subsequently discharged home. What is the principal diagnosis?
Fracture of hip
A patient's name is typically stored in a database as three data elements-last name, first name, and middle name- and not as a single data element. Which dimension of data quality is being applied when this occurs?
Granularity
The longitudinal health record of today can be influenced most significantly by which of the following activities?
Health Information Exchange
A patient is seen in the hospital emergency department with a complaint of shortness of breath. A chest X Ray reveals pneumonia and the ED physician administers an injection, then prescribes an antibiotic and discharges the patient. The coding system that will be utilized for this admission is
ICD-10-CM and CPT/HCPCS
Which group has the authority to suspend or terminate approved research that is not being conducted in accordance with research requirements or that has caused unexpected or serious harm to the subject?
IRB
A court assigns a person to "stand in the place of parents and possess their legal rights toward a child." This is called
In loco parentis
What must be in place to enhance the retrieval process for scanned documents?
Indexing System
In the Data, Information, Knowledge, and Wisdom (DIKW) pyramid, the following scenario is represented at which level in the pyramid: "Mr. Wright's blood pressure, pulse and respiration are 120/70,100, and 15?
Information
You need a system that will work with your existing system but not necessarily from the same vendor. What type of system are you looking for?
Interfaced
What type of data are naturally numeric, where the distance between two values had meaning but multiplying values and zero values has no interoperation?
Interval
The release of information from records at an alcohol-drug abuse center
Is strictly governed by federal regulations
Which of the following graphs would be best for the cancer registrar to use to display the 5 year survival rates of lung cancer patients in the year 20xx to 20xx at your hospital?
Line Graph
As the project manager for the upcoming EHR implementation, you ask your assistant to develop a work breakdown structure (WBS). Critical to implementation and project success, the WBS
List steps needed to complete the project
Policies which spell out the specific qualifications that physicians must demonstrate before they can practice medicine in the hospital and are considered legally binding
Medical staff bylaws
A researcher needs information on acute care hospital Medicare patients, specifically claims data which (includes demographic data, operating room, therapy, pharmacy), ICD-10 diagnosis and procedure codes and DRGs. The claims data file that can be accessed to obtain this information is
Medicare Provider Analysis and Review (MEDPAR)
Which of the following present on admission indicators could result in a reduction of reimbursement on a hospital inpatient admission?
N-NO
Malpractice is a form of
Negligence
What is the principal difference between net autopsy rate and adjusted hospital autopsy rate?
Net autopsy rate considers only inpatient deaths
With proper written authorization from a patient, Houston Hospital obtains a copy of the patients health record from Austin Hospital. Houston Hospital the releases the information from Auston Hospital to Dallas Hospital. This practice is
Never appropriate, bc medical information should not be re-disclosed
You are preparing a training program for specific functional areas of the department (e.g. coding, transcription). Which of the following is the primary factor to consider in developing an effective training program?
Objectives of each functional area
Jennifer submits a written request to Houston Hospital for a copy of her PHI on August 19. The information is stored offsite. By what date must the covered entity comply?
October 18 (60 days)
Master programs that manage the basic operations of the computer are called
Operating systems
An Advance Beneficiary Notice (ABN) is a document signed by the
Patient, indicating whether he/she wants to receive healthcare services that Medicare probably will not pay for.
Under the HIPAA Security Rule, these types of safeguards have to do with protection the environment.
Physical
Under the RBRVS physician payment system, each HCPCS/CPT code contains three components, each having assign relative value unit. These three components are
Physician work, practice expense, and malpractice insurance expense
PHI refers to _____________________- protected health information.
Protected
HIPAA Privacy rules
Provide a federal foundation for privacy requirements of health information.
Steve submitted a written authorization to request a copy of his medical record. However, Steve's psychiatrist has determined that access to his PHI might endanger his life or safety. What should the covered entity ddo concerning the request?
Provide an appeals process to Steve for the denial
Ethical obligations to the ____ include advocating changes when patterns or system problems are not in the best interest of the patient, reporting violation of practice standards to the proper authorities.
Public
Mary Ellen Smith has been an excellent biller for the past 5 years. Lately you notice that she has the highest error rate and lowest productivity rate of the entire billing section. She also seems to be distracted and unhappy. You have a conversation with her and she confides that she is having many "Personal Problems" that are causing her enormous stress. As her supervisor you
Refer her to the Employee Assistance Program
To compute the reimbursement to a particular hospital for a particular MS-DRG, multiply the hospital's base payment rate by the
Relative weight for the MS-DRG
Which of the following is an example of a clinical information system
Results reporting
A 17 year old patient requests her patient record be sent to her insurance company; the HIM professional would?
Return the request for authorization by patient/guardian
The four-digit number used by Medicare to group charges together by service area. These codes are also used in the Cost Report to group costs together by service area.
Revenue code
Semantic interoperability will be enhanced primarily through the use of
SNOMED-CT
Which of the following would be on top of a pyramid which was designed to show the most specific coding system at the top, with remaining layers progressively decreasing in specificity?
SNOMED-CT
Jessica is the leader of a project team working on the definition of the woman's health service line. Several departments are so enthusiastic about the progress that they ask for additions to the project. This is not uncommon, and is known as
Scope creep
Once all data are posted to a patients account, the claim can be reviewed for accuracy and completeness. Many facilities have internal auditing systems. The auditing systems rune each claim through a set of edits specifically designed for the various 3rd party payer. The auditing system identified data that have failed edits and flags the claim for correction. These "Internal auditing systems are called
Scrubbers
Which rule requires covered entities to assign a unique name and/ or number for identifying and tracking user identity?
Security Rule
Which of the following would require a Business Associate Agreement
Shred-it our shredding company
Which of the following is not a kind of technology that focuses on data security?
Smart cards
The federal physician self-referral statute is also known as the
Stark Law
Which of the following laws prohibits a physician from referring Medicare patients to clinical labs where they or a member of their family have a financial interest?
Stark law
Which is the most important consideration in the retention of records?
State retention Law
Written documents that assist an organization in achieving its objectives and carry out its mission statement are known as
Strategic plans
According to the HIPAA Privacy Rule, PHI can be sent to the entity listed as the patient's payor without patient authorization based on
TPO "Time, Place, Occasion" exception
Audit trails, encryption and firewalls are all examples of what type of safeguard according to the HIPAA Security Rule.
Technical
The HIM director receives a subpoena duces cecum on a current inpatient. There are no previous hospitalizations for this patient. The Director would
Tell the judge that the record is a current inpatient record and suggest a copy be sent
Which of the following employees would be considered expert under Fair Labor Standards Act?
The head of the Department of Health Information Services who is involved in decision making and planning 90% of the time.
Which of the following is an example of respondent superior?
The hospital is held responsible for a pharmacist medication error.
Of the following, which requester is NOT required to submit the patient's written authorization to obtain copies of the patient's medical record from the hospital?
The hospital's attorney
If a service is specifically excluded from coverage in an insurance policy, who must pay for the healthcare service, if it is provided?
The patient
In which scenario would the information consent requirement be waived?
The patient is alone, unconscious and delay in treatment would result in further harm
A primary focus of screen format and design in a health record computer application should be to ensure that
The user is capturing essential data elements
If a healthcare practice or facility receives high performance scores, which one of the following might happened?
They might receive financial incentives
Determine if this is a leading or non-leading query- Dear Doctor Johnson, Mrs. Smith, a 68 year old female with a history of osteoporosis was admitted with a fracture of the femur after falling from a set of bleachers to the ground. Coding guidelines require explicit physician documentation regarding that nature of the fracture. Based on the information provided could you please specify the etiology of the fracture.... Blah blah blah
This is a non-leading query
The difference between a decision support system and an information system is that an information system is
Transactional
The powers of the 3 branches of the federal government are documented in the
US Constitution
A 34-year-old male underwent upper GI endoscopy, which included visualization of the esophagus, stomach and duodenum. Durning endoscopy, brushing collected esophageal specimens and esophageal biopsy was performed. Upon review of CPT surgery code descriptions for 43235 and 43239, the coder assigned 43239 only (because 43235 is considered a component of the total procedure, 43239). Reporting both codes would be considered
Unbundling
The most common reason given for information system failure is _____________.
User resistance
A group of devices that connect to a local area network via radio waves is this type of network?
Wireless local area network
The supervisor over imaging was receiving frequent complaints from the scanning clerks regarding the prepping clerk's job performance. The scanning clerks stated that it was becoming difficult to maintain their productivity level because the prepping clerk was not processing the discharge charts in a timely manner. In order to get a clearer understanding of the situation, the supervisor asked the scanning clerk and the prepping clerk to complete a task list for a 2 week period. The supervisor is constructing a
Work distribution chart
Tort claims have to do with what?
Wrongful conduct that has caused harm in public law
If payment of a service or procedure is denied based on National Correct Coding Initiative (NCCI) edits, the provider
cannot seek payment from a Medicare beneficiary even if a ABN or a NEMB had been obtained
A patient comes to the physician's office complaining of a wart on his foot. The physician recommends removal. The patient sits on the examining table and raises his foot. This is an example of
consent implied by actions
A nurse employed by your hospital gossiped about a discharged inpatient, which resulted in the patients good reputation being questioned by his neighbor. This is known as
slander
