MIAMI PHI 2604 FINAL PAPER 2026 QUESTIONS
WITH ANSWERS GRADED A+
◉ querying a provider: Answer: the process of clarifying conflicting,
ambiguous, or incomplete information contained in the patient's
medical record
◉ benefits of query process forms: Answer: 1. improving the quality
of coding
2. improving the quality of medical record documentation
3. improve the quality of physician documentation
4. improve the accuracy of code assignment
◉ When is it necessary to query? Answer: It is not necessary to
query for every unaddressed issue in physician documentation;
internal policies and procedures should state the situations that
warrant a physician clarification.
◉ AHIMA defines query as: Answer: as a question posed to a
provider to obtain additional,
clarifying documentation to improve the specificity and
completeness of the data used to assign diagnosis and procedure
codes in the patient's health record
,◉ "ICD-9-CM Official Guidelines for Coding and Reporting" Answer:
the official rules for coding and reporting ICD-9-CM; approved by the
Cooperating Parties
◉ Cooperating Parties Answer: ...made up of the following four
organizations:
American Hospital Association (AHA)
American Health Information Management Association (AHIMA)
Centers for Medicare and Medicaid Services (CMS)
National Center for Health Statistics (NCHS)
◉ ICD-9-CM Official Guidelines for Coding and Reporting states:
Answer: *A joint effort between the health care provider and the
coding professional is essential to achieve complete and accurate
documentation, code assignment, and reporting of diagnoses and
procedures.
*These guidelines have been developed to assist both the healthcare
provider and the coding professional in identifying those diagnoses
and procedures that are to be reported.
*The importance of consistent, complete documentation in the
medical record cannot be overemphasized.
*Without such documentation accurate coding cannot be achieved.
*The entire record should be reviewed to determine the specific
reason for the encounter and the conditions treated.
, ◉ "provider" is defined as: Answer: any physician or other qualified
healthcare practitioner who is legally accountable for establishing
the patient's diagnosis
◉ ICD-9-CM guidelines apply to: Answer: all healthcare providers,
organizations, facilities, and entities regardless of size and function
◉ AHIMA Standards of Ethical Coding direct coders to: Answer:
"assign and report only the codes and data that are
clearly and consistently supported by health record documentation
in accordance with applicable code set and abstraction conventions,
rules, and guidelines."
◉ AHIMA Standards of Ethical Coding direct coders to query for:
Answer: clarification and additional documentation prior to code
assignment when there is conflicting, incomplete, or ambiguous
information in the health record regarding a significant reportable
condition or procedure or other reportable data element dependent
on health record documentation
◉ Organizations should establish a (query) process for: Answer:
"ensuring that the physician documents in the health record, (note)
any clarification or additional information resulting from
communication with coding staff; communication tools between
coding personnel and physicians... should never be used as a
WITH ANSWERS GRADED A+
◉ querying a provider: Answer: the process of clarifying conflicting,
ambiguous, or incomplete information contained in the patient's
medical record
◉ benefits of query process forms: Answer: 1. improving the quality
of coding
2. improving the quality of medical record documentation
3. improve the quality of physician documentation
4. improve the accuracy of code assignment
◉ When is it necessary to query? Answer: It is not necessary to
query for every unaddressed issue in physician documentation;
internal policies and procedures should state the situations that
warrant a physician clarification.
◉ AHIMA defines query as: Answer: as a question posed to a
provider to obtain additional,
clarifying documentation to improve the specificity and
completeness of the data used to assign diagnosis and procedure
codes in the patient's health record
,◉ "ICD-9-CM Official Guidelines for Coding and Reporting" Answer:
the official rules for coding and reporting ICD-9-CM; approved by the
Cooperating Parties
◉ Cooperating Parties Answer: ...made up of the following four
organizations:
American Hospital Association (AHA)
American Health Information Management Association (AHIMA)
Centers for Medicare and Medicaid Services (CMS)
National Center for Health Statistics (NCHS)
◉ ICD-9-CM Official Guidelines for Coding and Reporting states:
Answer: *A joint effort between the health care provider and the
coding professional is essential to achieve complete and accurate
documentation, code assignment, and reporting of diagnoses and
procedures.
*These guidelines have been developed to assist both the healthcare
provider and the coding professional in identifying those diagnoses
and procedures that are to be reported.
*The importance of consistent, complete documentation in the
medical record cannot be overemphasized.
*Without such documentation accurate coding cannot be achieved.
*The entire record should be reviewed to determine the specific
reason for the encounter and the conditions treated.
, ◉ "provider" is defined as: Answer: any physician or other qualified
healthcare practitioner who is legally accountable for establishing
the patient's diagnosis
◉ ICD-9-CM guidelines apply to: Answer: all healthcare providers,
organizations, facilities, and entities regardless of size and function
◉ AHIMA Standards of Ethical Coding direct coders to: Answer:
"assign and report only the codes and data that are
clearly and consistently supported by health record documentation
in accordance with applicable code set and abstraction conventions,
rules, and guidelines."
◉ AHIMA Standards of Ethical Coding direct coders to query for:
Answer: clarification and additional documentation prior to code
assignment when there is conflicting, incomplete, or ambiguous
information in the health record regarding a significant reportable
condition or procedure or other reportable data element dependent
on health record documentation
◉ Organizations should establish a (query) process for: Answer:
"ensuring that the physician documents in the health record, (note)
any clarification or additional information resulting from
communication with coding staff; communication tools between
coding personnel and physicians... should never be used as a
