Hu HI 225 Foundations of Classification, Compliance, & Reimbursement Methodologies FINAL READINESS GUIDE Q & S 2025/2026

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