AHIMA RHIA FINAL EXAM QUESTIONS
AND ANSWERS GRADED A+ ASSURED
SUCCESS NEW UPDATE 2025/2026, Exams
of Nursing
When a payer rejects a claim for payment, organization staff must determine the reason for
denial. If the denial was deemed due to eligibility determination, what process in the revenue
cycle failed to operate as intended?
a. Front-end process
b. Middle process
c. Back-end process
d. Support services a. Front-end process
Conducting an inventory of the facility's records, determining the format and location of record
storage, assigning each record a time period for preservation, and destroying records that are
no longer needed are all components of a:
a. Case-mix index
b. Master patient index
c. Health record matrix
d. Retention program d. Retention program
The steps in developing a record retention program include: conducting an inventory of the
facility's records, determining the format and location of record storage, assigning each record a
retention period, and destroying records that are no longer needed
In conducting a qualitative review, the clinical documentation specialist sees that the nursing
staff has documented the patient's skin integrity on admission to support the presence of a
stage I pressure ulcer. However, the physician's documentation is unclear as to whether this
condition was present on admission. How should the clinical documentation specialist proceed?
a. Note the condition as present on admission
b. Query the physician to determine if the condition was present on admission
1|Page
,c. Note the condition as unknown on admission
d. Note the condition as not present on admission b. Query the physician to determine if the
condition was present on admission
The time required to recoup the cost of an investment is called the:
a. Accounting rate of return
b. Budget cycle
c. Payback period
d. Depreciation c. Payback period
A coding service had 400 discharged accounts to code in March. The service coded 200 within 3
days, 100 within 5 days, 50 within 8 days, and 50 within 10 days. The average turnaround time
for coding in March was:
a. 3 days
b. 5 days
c. 6.5 days
d. 9 days b. 5 days
The process of releasing health record documentation originally created by a different provider
is called:
a. Privileged communication
b. Subpoena
c. Jurisdiction
d. Redisclosure d. Redisclosure
How are employee performance standards used?
a. To communicate performance expectations
b. To assign daily work
c. To describe the elements of a job
d. To prepare a job advertisement a. To communicate performance expectations
What is the most common type of security threat to a health information system?
2|Page
,a. External to the healthcare entity
b. Internal to the healthcare entity
c. Environmental in nature
d. Computer viruses b. Internal to the healthcare entity
An accrediting agency's published rules, which serve as the basis for comparative assessment
during the review or survey process, are called:
a. Accreditation controls
b. Accreditation guides
c. Accreditation policies
d. Accreditation standards d. Accreditation standards
A medical group practice has contracted with an HIM professional to help define the practice's
legal health record. Which of the following should the HIM professional perform first to identify
the components of the legal health record?
a. Develop a list of all data elements referencing patients that are included in both paper and
electronic systems of the practice
b. Develop a list of statutes, regulations, rules, and guidelines that contain requirements
affecting the release of health records
c. Perform a quality check on all health record systems in the practice
d. Develop a listing and categorize all information requests for health information over the past
two years b. Develop a list of statutes, regulations, rules, and guidelines that contain
requirements affecting the release of health records
When defining the legal health record in a healthcare entity, it is best practice to establish a
policy statement of the legal health record as well as a:
a. Case-mix index
b. Master patient index
c. Health record matrix
d. Retention schedule c. Health record matrix
Which of the following items are packaged under the Medicare hospital outpatient prospective
payment system (OPPS)?
3|Page
, a. Recovery room and medical visits
b. Medical visits and supplies (other than pass-through)
c. Anesthesia and ambulance services
d. Supplies (other than pass-through) and recovery room d. Supplies (other than pass-
through) and recovery room
Mrs. Smith's admitting data indicates that her birth date is March 21, 1948. On the discharge
summary, Mrs. Smith's birth date is recorded as July 21, 1948. Which data quality element is
missing from Mrs. Smith's health record?
a. Data accuracy
b. Data consistency
c. Data accessibility
d. Data comprehensiveness b. Data consistency
The key to an effective retention and retrieval system of health records in a facility is:
a. Master patient index
b. Terminal digit filing
c. Microfilm
d. Optical imaging a. Master patient index
Most facilities begin counting days in accounts receivable at which of the following times?
a. Date the patient registers
b. Date the patient is discharged
c. Date the claim drops
d. Date the claim is received by the payer c. Date the claim drops
One of the medical staff committees at St. Vincent Hospital is responsible for reviewing cases of
patients readmitted within 14 days after discharge. This review of the patients' health records is
considered healthcare:
a. Actions
b. Operations
4|Page
AND ANSWERS GRADED A+ ASSURED
SUCCESS NEW UPDATE 2025/2026, Exams
of Nursing
When a payer rejects a claim for payment, organization staff must determine the reason for
denial. If the denial was deemed due to eligibility determination, what process in the revenue
cycle failed to operate as intended?
a. Front-end process
b. Middle process
c. Back-end process
d. Support services a. Front-end process
Conducting an inventory of the facility's records, determining the format and location of record
storage, assigning each record a time period for preservation, and destroying records that are
no longer needed are all components of a:
a. Case-mix index
b. Master patient index
c. Health record matrix
d. Retention program d. Retention program
The steps in developing a record retention program include: conducting an inventory of the
facility's records, determining the format and location of record storage, assigning each record a
retention period, and destroying records that are no longer needed
In conducting a qualitative review, the clinical documentation specialist sees that the nursing
staff has documented the patient's skin integrity on admission to support the presence of a
stage I pressure ulcer. However, the physician's documentation is unclear as to whether this
condition was present on admission. How should the clinical documentation specialist proceed?
a. Note the condition as present on admission
b. Query the physician to determine if the condition was present on admission
1|Page
,c. Note the condition as unknown on admission
d. Note the condition as not present on admission b. Query the physician to determine if the
condition was present on admission
The time required to recoup the cost of an investment is called the:
a. Accounting rate of return
b. Budget cycle
c. Payback period
d. Depreciation c. Payback period
A coding service had 400 discharged accounts to code in March. The service coded 200 within 3
days, 100 within 5 days, 50 within 8 days, and 50 within 10 days. The average turnaround time
for coding in March was:
a. 3 days
b. 5 days
c. 6.5 days
d. 9 days b. 5 days
The process of releasing health record documentation originally created by a different provider
is called:
a. Privileged communication
b. Subpoena
c. Jurisdiction
d. Redisclosure d. Redisclosure
How are employee performance standards used?
a. To communicate performance expectations
b. To assign daily work
c. To describe the elements of a job
d. To prepare a job advertisement a. To communicate performance expectations
What is the most common type of security threat to a health information system?
2|Page
,a. External to the healthcare entity
b. Internal to the healthcare entity
c. Environmental in nature
d. Computer viruses b. Internal to the healthcare entity
An accrediting agency's published rules, which serve as the basis for comparative assessment
during the review or survey process, are called:
a. Accreditation controls
b. Accreditation guides
c. Accreditation policies
d. Accreditation standards d. Accreditation standards
A medical group practice has contracted with an HIM professional to help define the practice's
legal health record. Which of the following should the HIM professional perform first to identify
the components of the legal health record?
a. Develop a list of all data elements referencing patients that are included in both paper and
electronic systems of the practice
b. Develop a list of statutes, regulations, rules, and guidelines that contain requirements
affecting the release of health records
c. Perform a quality check on all health record systems in the practice
d. Develop a listing and categorize all information requests for health information over the past
two years b. Develop a list of statutes, regulations, rules, and guidelines that contain
requirements affecting the release of health records
When defining the legal health record in a healthcare entity, it is best practice to establish a
policy statement of the legal health record as well as a:
a. Case-mix index
b. Master patient index
c. Health record matrix
d. Retention schedule c. Health record matrix
Which of the following items are packaged under the Medicare hospital outpatient prospective
payment system (OPPS)?
3|Page
, a. Recovery room and medical visits
b. Medical visits and supplies (other than pass-through)
c. Anesthesia and ambulance services
d. Supplies (other than pass-through) and recovery room d. Supplies (other than pass-
through) and recovery room
Mrs. Smith's admitting data indicates that her birth date is March 21, 1948. On the discharge
summary, Mrs. Smith's birth date is recorded as July 21, 1948. Which data quality element is
missing from Mrs. Smith's health record?
a. Data accuracy
b. Data consistency
c. Data accessibility
d. Data comprehensiveness b. Data consistency
The key to an effective retention and retrieval system of health records in a facility is:
a. Master patient index
b. Terminal digit filing
c. Microfilm
d. Optical imaging a. Master patient index
Most facilities begin counting days in accounts receivable at which of the following times?
a. Date the patient registers
b. Date the patient is discharged
c. Date the claim drops
d. Date the claim is received by the payer c. Date the claim drops
One of the medical staff committees at St. Vincent Hospital is responsible for reviewing cases of
patients readmitted within 14 days after discharge. This review of the patients' health records is
considered healthcare:
a. Actions
b. Operations
4|Page
