HAAD RHIA Exam (page: 67)
HAAD Registered Health Information Administrator (RHIA)
Updated on: 17-Feb-2026

Viewing Page 67 of 367

Home health agencies are reimbursed on a prospective payment system (PPS) for Medicare patients. This PPS is called

  1. home health resource groups (HHRGs).
  2. case-mix groups (CMGs).
  3. diagnosis-related groups (DRGs).
  4. resource utilization groups (RUGs).

Answer(s): A



These are assigned to every HCPCS/CPT code under the Medicare hospital outpatient prospective payment system to identify how the service or procedure described by the code would be paid.

  1. geographic practice cost indices
  2. major diagnostic categories
  3. minimum data set
  4. payment status indicator

Answer(s): D



This means that the service or procedure is reasonable and necessary for the diagnosis or treatment of illness or injury consistent with generally accepted standards of care.

  1. peer review
  2. optimization
  3. benchmarking
  4. medical necessity

Answer(s): D



The first step is

  1. cases are differentiated based on the presence or absence of complications/comorbidites (CCs) or major complications/comorbidites (MCCs).
  2. cases are divided into either a surgical partition or a medical partition.
  3. the principal diagnosis determines the MDC assignment.
  4. diagnoses and procedures are coded using ICD-9-CM.

Answer(s): D



The second step is

  1. cases are differentiated based on the presence or absence of complications/ comorbidites (CCs) or major complications comorbidites (MCCS).
  2. cases are divided into either a surgical partition or a medical partition.
  3. the principal diagnosis determines the MDC assignment.
  4. diagnoses and procedures are coded using ICD-9-CM.

Answer(s): C



Viewing Page 67 of 367



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