RHIA Clinical Classification Systems and Coding 2

Question 1

ICD-10-PCS codes differ from ICD-10-CM codes in that they are used to classify what?

Accepted Answer

Inpatient procedures performed in a hospital

Answer

Diagnoses for outpatient encounters

Answer

Physician office evaluation and management services

Answer

Durable medical equipment claims

Question 2

A Present on Admission (POA) indicator of 'N' means the condition was:

Accepted Answer

Not present at the time of inpatient admission

Answer

Present at the time of inpatient admission

Answer

Clinically undetermined at admission

Answer

Exempt from POA reporting

Question 3

In the MS-DRG system, a Major Complication or Comorbidity (MCC) does what compared to a CC?

Accepted Answer

Typically results in higher reimbursement than a CC

Answer

Results in lower reimbursement than a CC

Answer

Has less clinical severity than a CC

Answer

Does not affect DRG assignment

Question 4

When should a coder initiate a physician query?

Accepted Answer

When clinical indicators suggest a diagnosis that is not documented

Answer

Whenever the coder disagrees with the physician's treatment plan

Answer

Only after the patient has been discharged

Answer

When the physician has provided too many diagnoses

Question 5

Which outpatient coding guideline states that uncertain diagnoses (e.g., 'possible,' 'probable') should NOT be coded?

Accepted Answer

ICD-10-CM Official Guidelines for outpatient coding

Answer

Uniform Hospital Discharge Data Set guideline

Answer

UHDDS principal diagnosis rule

Answer

AHIMA outpatient coding guidelines

Question 6

The Alphabetic Index in ICD-10-CM serves what primary function?

Accepted Answer

Directs the coder to the appropriate code or range in the Tabular List

Answer

Provides the final, definitive code to report on the claim

Answer

Lists all valid procedure codes in sequence

Answer

Contains official coding guidelines and conventions

Question 7

Ambulatory Payment Classifications (APCs) are used under which Medicare payment system?

Accepted Answer

Hospital Outpatient Prospective Payment System (OPPS)

Answer

Inpatient Prospective Payment System (IPPS)

Answer

Skilled Nursing Facility PPS

Answer

Home Health PPS