2009 RHIA/RHIT Review Guide Errata Page Question Comments Table of Contents ix Carol A. Venable, MPH, RHIA, FAHIMA (correct MHP to read MPH) Health Data Content and Standards 46 42 Correct answer: C Change explanation in answer key to read: In the past, a recommendation for improvement from the Joint Commission was indicated if the number of delinquent records was greater than 50% or if the percentage of records with delinquent records due to missing H&Ps exceeded 2% of the average monthly discharges. In the month of April, both of these delinquency problems were reflected. However, since the percentages of delinquency of the records is now the standard, the correct answer would be the month of June since it had the highest percentage of delinquent records Health Data Content and Standards 50 90 Correct answer: B Change answer key to read: In the past, a recommendation for improvement from the Joint Commission was indicated if the number of delinquent records was greater than 50% or if the percentage of records with delinquent records due to missing H&Ps exceeded 2% of the average monthly discharges. Additionally, if the percentage of delinquent operative reports was over 2%, it was viewed as being a more serious deficiencies since operative reports should be completed immediately after surgery, not post discharge. The incomplete record rate of 55%, but the percentage of records that are not complete have not met the criteria for delinquent records. The delinquent record rate is 32% which does not exceed the Joint Commission requirements of exceeding 50% delinquency. With this in mind, even though the delinquent records do not exceed 50%, answer B would have to be correct. 2009 RHIA/RHIT Review Guide Errata (continued) Page Question Comments Medical Science 149 17 Correct option D to read: either staphylococcus or streptococcus 164 Correct answer: D Two types of bacteria cause impetigo — Staphylococcus aureus (staph), which is most common, and Streptococcus pyogenes (strep). Both types of bacteria can live harmlessly on your skin until they enter through a cut or other wound and cause an infection. 164 65 Correct answer: D 164 83 Correct Answer is: D Information on vaginitis to support answer in book. The most common types of vaginitis are: Bacterial vaginosis. This type of vaginitis results from overgrowth of one of several organisms normally present in your vagina, upsetting the natural balance of vaginal bacteria. Yeast infections. A naturally occurring fungus called Candida albicans usually causes this type of vaginitis. An estimated three out of four women will have a yeast infection in their lifetimes. Trichomoniasis. This type is caused by a parasite and is commonly transmitted by sexual intercourse. Atrophic vaginitis. This type results from reduced estrogen levels after menopause. The vaginal tissues become thinner and drier, which may lead to itching, burning or pain. Medical Billing and Reimbursement 139 34 Under the outpatient prospective payment system (OPPS), status indicator “___” is a payment indicator that refers to “significant procedures for which the multiple procedure reduction applies”. This means that the reported CPT and/or HCPCS Level II code will be paid a discounted APC reimbursement rate when reported with other procedures on the same claim. A. “T” C. “S” B. “X” D. “A” REFERENCE: Green & Rowell, p 286 Green, p 847 Correct answer: A 122 39 Please omit using this question. 2009 RHIA/RHIT Review Guide Errata (continued) Page Question Comments ICD-9-CM 169 2 Option “B” should read: B: 038.11, V09.0, 707.03, 995.92, 785.52, 707.20, 38.93, 00.11 175 39 Answer option “D” should read: 410.41, 414.00, 427.31 178 59 Answer option “C” should read: C: 403.90, 250.41, 585.9, V58.67 182 88 Answer “D” should read: D: 771.82, 041.4 188 115 Question should read: The patient has hypertensive heart disease and nephrosclerosis with end stage renal disease 220 116 Correct answer is “A”. 196 138 Add codes to box: 250.32 Diabetes mellitus with other coma, type II or unspecified type, uncontrolled 250.52 Diabetes mellitus with ophthalmic manifestations, type II or unspecified type, uncontrolled Answer option “C” should read: C: 250.32, 250.52, 366.41 220 Explanation should read: Diabetic ketoacidosis by definition is uncontrolled. 200 148 Correct option for code 303.90 in box: 303.90 Other and unspecified alcohol dependence, unspecified Add option for code 303.91 in box: 303.91 Other and unspecified alcohol dependence, continuous Answer “C” should read 303.90, 535.30 220 Add explanation to answer key: The term “continuous” refers to daily intake of large amounts of alcohol, or regular heavy drinking on weekends or days off. The coder should not assume to use the fifth digit 1 unless documented as continuous. CPT Coding 227- 10-18 Questions from anesthesia need to have “anesthesia for” added at the beginning of the question on the 228 interactive CD so that students know use the anesthesia code. 237 72 Answer “A” should read: A: 43260, 43262, 43264 244 117 Answer “D” should read: D: 59300 253 186 Last sentence of question should read: The decubitus ulcer was debrided down to the bone. Add code option 707.20 to option box: 707.20 Pressure ulcer unspecified stage Answer “C” should read: C: 250.80, 707.06, 707.20, 11044 2009 RHIA/RHIT Review Guide Errata (continued) Page Question Comments 256 191 Add code option -25 to code box: -25 Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service. Answer “D” should read: D: 841.9, E927.2, 99281-25, 73080 257 193 Add option -59 to code option box: -59 Distinct procedural service Answer “B” should read: B: 727.61, 29826-59, 23412 272 Add to answer explanation: Modifier -59 must be added to code 29826 because it is a component of comprehensive procedure 23412. That is allowed if an appropriate modifier is used per NCCI edits. 269 231 Laparoscopic takedown of the splenic flexure and a partial colectomy with anastomosis A. 44203, 44213 C. 44213 B. 44204 D. 44204, 44213 REFERENCE: CPT Assistant, April 2006, p 19 Correction: Codes in answer A should read: 44203, 44213 Answer D is correct. 269 232 Laryngoscopic submucosal removal of non-neoplastic lesion of the vocal cord with graft reconstruction. An operating microscope was used. A. 31546, 69990 C. 31546 B. 31546, 20926 D. 31546, 20926-51 REFERENCE: CPT Assistant, May 2006, p 16-17 Correction: First word in question should be: Laryngoscopic. 271 119 When tubal ligation is performed at the same time as hysterotomy, use 58611 in addition to 59100 Mock Examination 542 170 Typographical error: change HER to EHR in the question.
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