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D521 INTRODUCTION TO MEDICAL
CODING WGU PA BRAND NEW
ACTUAL EXAM WITH ANSWERS.
Ensuring appropriate charges are present for a certain
diagnosis
What is a common activity involved in revenue integrity
programs?
Using custom diagnosis codes for each patient served
Increasing the volume of collected patient data
Streamlining services to only those that are medically necessary
Ensuring appropriate charges are present for a certain diagnosis
Cash slowdowns
What do providers that underperform in revenue integrity risk?
Higher claim numbers
Cash slowdowns
Inaccurate diagnoses
Low reimbursement rates
A service that is not rendered
Which type of claimed service is considered a false claim based
on the False Claims Act?
A service that relates to a hospital-acquired condition
A service that is not rendered
A service that does not address the principal diagnosis
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A service that was provided by an assistant rather than a
physician
U.S. Department of Health and Human Services
What is one of the government agencies actively involved in the
prevention of fraud in healthcare?
Defense Commissary Agency
U.S. Department of the Interior
U.S. Department of Health and Human Services
U.S. Department of Commerce
Submitting multiple claims for the same service
What is an example of a type of fraud?
Charging for a treatment procedure that was not successful
Offering discounted rates to patients without insurance
Submitting multiple claims for the same service
Transferring a patient to another facility
Exclusion Statute
What is the federal legislation that prohibits certain entities from
participating in healthcare programs?
Stark Law
False Claims Act
Anti-Kickback Statute
Exclusion Statute
Revocation
What is the defined disciplinary action of AHIMA that refers to a
loss of certification status and removal from the registry?
Censure
Revocation
Probation
Suspension
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Maintaining protected information confidentiality
What is one component of the AHIMA Standards of Ethical
Coding?
Assigning codes that optimize DRG assignment
Accessing patient information from outside the medical facility
Ensuring there is a broad mix of DRGs being assigned
Maintaining protected information confidentiality
Auditing charges on a daily basis
Which activity is a common revenue integrity component?
Streamlining services to only those that are medically necessary
Auditing charges on a daily basis
Educating patients on service bills
Reducing equipment and supplies costs
Surgical in nature
What is one characteristic that leads to a classification as a
significant procedure for hospital inpatients?
Surgical in nature
Performed by a physician
Requires a device
Managed with medication
Cutting out or off without replacement
Which root operation grouping for the medical and surgical
section contains excision?
Moving or putting back some or all of a body part
Removing solids, fluids, or gases from a body part
Removing some or all of a body part
Cutting out or off without replacement
D521 INTRODUCTION TO MEDICAL
CODING WGU PA BRAND NEW
ACTUAL EXAM WITH ANSWERS.
Ensuring appropriate charges are present for a certain
diagnosis
What is a common activity involved in revenue integrity
programs?
Using custom diagnosis codes for each patient served
Increasing the volume of collected patient data
Streamlining services to only those that are medically necessary
Ensuring appropriate charges are present for a certain diagnosis
Cash slowdowns
What do providers that underperform in revenue integrity risk?
Higher claim numbers
Cash slowdowns
Inaccurate diagnoses
Low reimbursement rates
A service that is not rendered
Which type of claimed service is considered a false claim based
on the False Claims Act?
A service that relates to a hospital-acquired condition
A service that is not rendered
A service that does not address the principal diagnosis
, Page | 2
A service that was provided by an assistant rather than a
physician
U.S. Department of Health and Human Services
What is one of the government agencies actively involved in the
prevention of fraud in healthcare?
Defense Commissary Agency
U.S. Department of the Interior
U.S. Department of Health and Human Services
U.S. Department of Commerce
Submitting multiple claims for the same service
What is an example of a type of fraud?
Charging for a treatment procedure that was not successful
Offering discounted rates to patients without insurance
Submitting multiple claims for the same service
Transferring a patient to another facility
Exclusion Statute
What is the federal legislation that prohibits certain entities from
participating in healthcare programs?
Stark Law
False Claims Act
Anti-Kickback Statute
Exclusion Statute
Revocation
What is the defined disciplinary action of AHIMA that refers to a
loss of certification status and removal from the registry?
Censure
Revocation
Probation
Suspension
, Page | 3
Maintaining protected information confidentiality
What is one component of the AHIMA Standards of Ethical
Coding?
Assigning codes that optimize DRG assignment
Accessing patient information from outside the medical facility
Ensuring there is a broad mix of DRGs being assigned
Maintaining protected information confidentiality
Auditing charges on a daily basis
Which activity is a common revenue integrity component?
Streamlining services to only those that are medically necessary
Auditing charges on a daily basis
Educating patients on service bills
Reducing equipment and supplies costs
Surgical in nature
What is one characteristic that leads to a classification as a
significant procedure for hospital inpatients?
Surgical in nature
Performed by a physician
Requires a device
Managed with medication
Cutting out or off without replacement
Which root operation grouping for the medical and surgical
section contains excision?
Moving or putting back some or all of a body part
Removing solids, fluids, or gases from a body part
Removing some or all of a body part
Cutting out or off without replacement
