Free RHIA Practice Test

1. A study focuses on determining the proportion of patients with dental problems whose care plans adhere to the American Dental Association's guidelines. Which dimension of performance is addressed by this study?

a. efficacy
b. appropriateness
c. continuity
d. efficiency

2. Which Medicare reimbursement methodology is used in physician offices and clinics?

a. prospective payment system per diem
b. ambulatory surgery center groups
c. prospective payment system based on diagnosis-related groups
d. resources-based relative value system

3. What is the mode of the data set below? (1, 4, 6, 6, 8, 9, 12, 15, 18)

a. 1
b. 6
c. 8
d. 9

4. Which of the following is a disadvantage of the prevalence study design?

a. It is expensive.
b. It is ineffective for the study of rare diseases.
c. It rarely leads to secondary research.
d. It takes a long time to produce observable results.

5. Which of the following coding systems is used in skilled nursing facilities?

a. ICD-9-CM, vol. 3
b. HCPCS/CPT
c. HCFA I 500 billing form
d. UB-92 billing form

Answers & Explanations

1. A: The dimension of performance addressed by this study is efficacy. When used to describe the provision of health services, efficacy is the extent to which an activity achieves its intended outcome. The study in this question, then, is measuring the efficacy of the guidelines provided by the American Dental Association. It is important for a medical service authority to understand how often and how exactly its recommendations are followed. The appropriateness of an activity is the extent to which it applies to the clinical needs of the patient. Continuity is the extent to which multiple healthcare providers are able to coordinate and maintain consistent therapy for patients over a long duration. Finally, the efficiency of healthcare activity is the extent to which desired outcomes are achieved with a minimum use of resources.

2. D: The resources-based relative value system is the Medicare reimbursement methodology used in physician offices and clinics. In this system, services are compared to a standard value of 1.0. In other words, a service that is two-and-a-half times as significant as the standard service will receive a value of 2.5. The prospective payment system per diem is used in skilled nursing facilities. The ambulatory surgery center groups reimbursement system is used in freestanding ambulatory surgery centers. The prospective payment system based on diagnosis-related groups is used by hospital inpatient facilities.

3. B: The mode of the data set is 6. In statistics, the mode of a data set is the value that appears most often. In the given data set, the only value that appears more than once is 6. It is also important to know how to calculate the mean and median of a data set. The mean, also known as the average, is calculated by adding the values together and dividing by the number of values in the set. For this set, the mean would be calculated as follows: (1 + 4 + 6 + 6 + 8 + 9 + 12 + 15 + 18) / 9 = 8.78. The median of a data set is the value that falls in the middle when the values are placed in order from least to greatest. For this data set, the median is 8.

4. B: One disadvantage of the prevalence study design is that it is ineffective for the study of rare diseases. The prevalence study design measures the distribution of symptoms or diseases in different populations at a particular moment. This case study design is very useful for generating hypotheses that can be tested through subsequent research. It is typically inexpensive, and tends to produce observable results quickly. However, prevalence studies are unable to suggest causal relationships, and their use is limited to those members of the population who are still alive to be tested.

5. D:The UB-92 billing form is the coding system used in skilled nursing facilities. These facilities also use the first two volumes of the ICD-9-CM coding system. The ICD-9-CM, vol. 3 is used in hospital inpatient and outpatient facilities, as well as in hospital-based ambulatory surgery centers. It is often used in freestanding ambulatory surgery centers. The HCPCS/CPT billing form is required for Medicare in hospital outpatient and hospital-based ambulatory surgery centers. It is also used in freestanding ambulatory surgery centers and physician offices and clinics. The HCFA I 500 billing form is used in freestanding ambulatory surgery centers and physician offices and clinics.

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Last Updated: 07/05/2017


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