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Hu HI 225 Foundations of Classification, Compliance, & Reimbursement Methodologies FINAL READINESS GUIDE Q & S 2026/2027
1. What is the primary purpose of the ICD coding system?
- A) To ensure hospital profitability
- B) To improve patient care
- C) To create standardized data for health management
and billing
- D) To facilitate surgical interventions
- Correct Answer: C
- Rationale: The ICD (International Classification of
Diseases) coding system standardizes data for morbidity
and mortality statistics, billing, and health management.
2. Which of the following reimbursement methodologies is
based on diagnosis-related groups (DRGs)?
- A) Fee-for-service
- B) Capitation
- C) Bundled payments
- D) Prospective payment system
- Correct Answer: D
- Rationale: The Prospective Payment System (PPS)
uses DRGs to determine payment amounts based on
patient diagnoses.
3. During an audit, a discrepancy is identified between the
medical records and the coded data submitted for
reimbursement. What is the most appropriate action?
- A) Ignore the discrepancy
- B) Revise the coding to match the reimbursement claim
- C) Investigate the discrepancy further to ensure
compliance
- D) Inform the patient immediately
- Correct Answer: C
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