RHIA Exam Domain 4 with Complete
Solutions
A 45‐year‐old woman is admitted for blood loss anemia due to dysfunctional uterine
bleeding.
· D50.0, N93.8
· D62, N93.8
· N93.8, D50.0
· D50.0, D25.9 - ANS-
A coder notes that the patient is taking prescribed Haldol. The final diagnoses on the
progress notes include diabetes mellitus, acute pharyngitis, and malnutrition. What
condition might the coder suspect the patient has that the physician should be queried
to confirm?
· Insomnia
· Hypertension
· Mental or behavioral problems
· Rheumatoid arthritis - ANS-Mental or behavioral problems
A coding audit shows that an inpatient coder is using multiple codes that describe the
individual components of a procedure rather than using a single code that describes all
the steps of the procedure performed. Which of the following should be done in this
case?
· Require all coders to implement this practice
· Report the practice to the OIG
· Counsel the coder to stop the practice immediately
· Put the coder on an unpaid leave of absence - ANS-Counsel the coder to stop the
practice immediately
A comprehensive retrospective review should be conducted at least once a year of what
aspect of the CDI program?
· Proficiency statistics
· Compliance issues
· All query opportunities
· Core key measures - ANS-All query opportunities
A patient arrived via ambulance to the emergency department following a motor vehicle
accident. The patient sustained a fracture of the ankle, a 3.0cm superficial laceration of
the left arm, a 5.0‐cm laceration of the scalp with exposure of the fascia, and a
concussion. The patient received the following procedures: x‐ray of the ankle that
showed a bimalleolar ankle fracture requiring closed manipulative reduction, simple
, suturing of the arm laceration, and layer closure of the scalp. Provide CPT codes for the
procedures performed in the emergency department for the facility bill.
· 27810, 12032
· 27818, 12004, 12032‐58
· 27810, 12032, 12002‐59
· 27810, 12004 - ANS-27810, 12032, 12002‐59
A patient has a malunion of an intertrochanteric fracture of the right hip that is treated
with a proximal femoral osteotomy by incision. What is the correct ICD‐10‐PCS code for
this procedure?
· 0QB60ZZ
· 0Q860ZZ
· 0SB90ZZ
· 0SN90ZZ - ANS-0Q860ZZ
A patient is admitted with right diabetic cataract and extracapsular cataract extraction
with simultaneous insertion of intraocular lens.
· H25.9, E11.36, 08DJ3ZZ
· E11.36, 08RJ3JZ
· E11.9, E11.36, H26.9, 08DJ3ZZ
· E25.9, E11.9, 08RJ3JZ - ANS-
A patient saw a neurosurgeon for treatment of a nerve that was severed in an industrial
accident. The patient worked for Basic Manufacturing Company where the industrial
accident occurred. Basic Manufacturing carried workers' compensation insurance. The
workers' compensation insurance paid the neurosurgeon fees. Which entity is the "third
party"?
· Patient
· Neurosurgeon
· Basic Manufacturing Company
· Workers' compensation insurance - ANS-Workers' compensation insurance
A physician performed a total abdominal hysterectomy with bilateral salpingo‐
oophorectomy on his patient at Community Hospital. His office billed the following:
58150 Total abdominal hysterectomy (corpus and cervix), with or without removal of
tube(s), with or without removal of ovary(s)
58720 Salpingo‐oophorectomy, complete or partial, unilateral or bilateral (separate
procedure)
Why was this claim rejected?
· Billed hysterectomy with wrong CPT code
· Not a covered procedure
· Unbundled procedures
· Covered procedure but insurance company requires additional information - ANS-
Unbundled procedures
Solutions
A 45‐year‐old woman is admitted for blood loss anemia due to dysfunctional uterine
bleeding.
· D50.0, N93.8
· D62, N93.8
· N93.8, D50.0
· D50.0, D25.9 - ANS-
A coder notes that the patient is taking prescribed Haldol. The final diagnoses on the
progress notes include diabetes mellitus, acute pharyngitis, and malnutrition. What
condition might the coder suspect the patient has that the physician should be queried
to confirm?
· Insomnia
· Hypertension
· Mental or behavioral problems
· Rheumatoid arthritis - ANS-Mental or behavioral problems
A coding audit shows that an inpatient coder is using multiple codes that describe the
individual components of a procedure rather than using a single code that describes all
the steps of the procedure performed. Which of the following should be done in this
case?
· Require all coders to implement this practice
· Report the practice to the OIG
· Counsel the coder to stop the practice immediately
· Put the coder on an unpaid leave of absence - ANS-Counsel the coder to stop the
practice immediately
A comprehensive retrospective review should be conducted at least once a year of what
aspect of the CDI program?
· Proficiency statistics
· Compliance issues
· All query opportunities
· Core key measures - ANS-All query opportunities
A patient arrived via ambulance to the emergency department following a motor vehicle
accident. The patient sustained a fracture of the ankle, a 3.0cm superficial laceration of
the left arm, a 5.0‐cm laceration of the scalp with exposure of the fascia, and a
concussion. The patient received the following procedures: x‐ray of the ankle that
showed a bimalleolar ankle fracture requiring closed manipulative reduction, simple
, suturing of the arm laceration, and layer closure of the scalp. Provide CPT codes for the
procedures performed in the emergency department for the facility bill.
· 27810, 12032
· 27818, 12004, 12032‐58
· 27810, 12032, 12002‐59
· 27810, 12004 - ANS-27810, 12032, 12002‐59
A patient has a malunion of an intertrochanteric fracture of the right hip that is treated
with a proximal femoral osteotomy by incision. What is the correct ICD‐10‐PCS code for
this procedure?
· 0QB60ZZ
· 0Q860ZZ
· 0SB90ZZ
· 0SN90ZZ - ANS-0Q860ZZ
A patient is admitted with right diabetic cataract and extracapsular cataract extraction
with simultaneous insertion of intraocular lens.
· H25.9, E11.36, 08DJ3ZZ
· E11.36, 08RJ3JZ
· E11.9, E11.36, H26.9, 08DJ3ZZ
· E25.9, E11.9, 08RJ3JZ - ANS-
A patient saw a neurosurgeon for treatment of a nerve that was severed in an industrial
accident. The patient worked for Basic Manufacturing Company where the industrial
accident occurred. Basic Manufacturing carried workers' compensation insurance. The
workers' compensation insurance paid the neurosurgeon fees. Which entity is the "third
party"?
· Patient
· Neurosurgeon
· Basic Manufacturing Company
· Workers' compensation insurance - ANS-Workers' compensation insurance
A physician performed a total abdominal hysterectomy with bilateral salpingo‐
oophorectomy on his patient at Community Hospital. His office billed the following:
58150 Total abdominal hysterectomy (corpus and cervix), with or without removal of
tube(s), with or without removal of ovary(s)
58720 Salpingo‐oophorectomy, complete or partial, unilateral or bilateral (separate
procedure)
Why was this claim rejected?
· Billed hysterectomy with wrong CPT code
· Not a covered procedure
· Unbundled procedures
· Covered procedure but insurance company requires additional information - ANS-
Unbundled procedures
