RHIA Practice Questions (2026) — Free Sample Questions with Answers

Answer: B

Duplicate: A duplicate is when one patient has two or more MPI entries or medical record numbers in the same facility. Here, information was filed in a different person's record.

Overlay: Correct. An overlay happens when one patient's information is placed in another patient's existing record. This creates a patient-safety risk, so the records must be corrected and separated.

Overlap: An overlap is when one patient has different medical record numbers across facilities in the same enterprise. Data has not been mixed between two people.

Merge: A merge is the corrective process of combining true duplicate records for the same patient. It is not the error itself.

Duplicate = one patient, two records (same facility). Overlap = one patient, several records across the enterprise. Overlay = two patients' data in one record, the most dangerous error.

Answer: A

Release the record set but withhold the separately kept psychotherapy notes: Correct. Psychotherapy notes kept separately are excluded from the HIPAA right of access. The patient still has a right to the rest of the designated record set.

Deny the entire request because all mental health records are excluded from access: HIPAA does not exclude mental health records in general. Only psychotherapy notes kept separately (and a few other categories) are excluded.

Release everything, including the psychotherapy notes, without exception: HIPAA does not require release of separately kept psychotherapy notes under the right of access. The therapist may choose to share them.

Require a court order before releasing any portion of the record: A patient's own access request does not need a court order. It is a right under the Privacy Rule.

Psychotherapy notes (kept separately) are excluded from the right of access and need specific authorization for most disclosures. The rest of the designated record set stays accessible.

Answer: B

82.3%: This uses 31 days: 5,100 ÷ (200 × 31). June has 30 days, so the bed count days are 6,000.

85.0%: Correct. Bed occupancy = inpatient service days ÷ (bed count × days in period) × 100 = 5,100 ÷ (200 × 30) × 100 = 5,100 ÷ 6,000 = 85.0%.

87.5%: This does not match the formula. It would need 5,250 service days or a smaller bed count.

117.6%: This inverts the formula (6,000 ÷ 5,100). Occupancy is service days divided by available bed days.

Bed occupancy % = inpatient service days ÷ (beds × days in period) × 100. Use the actual number of days in the month.

Answer: D

The condition that used the most hospital resources during the inpatient stay: Resource use does not decide principal diagnosis selection. A condition can use many resources without being the reason for admission.

The condition the admitting physician listed first on the admission order: The admitting diagnosis is a working diagnosis. The principal diagnosis is decided after study and may differ from it.

The diagnosis giving the highest-weighted MS-DRG for the claim: Choosing a diagnosis to maximize payment is non-compliant (upcoding) and is not the UHDDS definition.

The condition found after study to be chiefly responsible for the admission: Correct. UHDDS defines the principal diagnosis as the condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital.

Principal diagnosis = 'after study,' the condition chiefly responsible for the admission. It is not the most expensive, the first listed or the highest-paying condition.

Answer: B

Refreezing by updating policies to lock in the new process: Refreezing comes last, making the change stick once it has been adopted.

Unfreezing by explaining why the change is needed and involving staff: Correct. Lewin's first stage, unfreezing, reduces resistance by showing why the current state must change (for example, errors, compliance risk) and involving staff before the change.

Changing by switching off the paper log on the first day: Forcing the change without preparation tends to increase resistance. The moving or changing stage comes after unfreezing.

Disciplining staff who continue to use the paper log: Starting with punishment ignores the cause of resistance and damages engagement. It is not a stage of Lewin's model.

Lewin: unfreeze (build readiness, explain the need) → change (implement with support) → refreeze (make it standard).

Answer: C

3.75 FTE: This uses 8 productive hours a day (3 × 8 × 20 = 480 per coder). The scenario gives 7 productive hours.

6.43 FTE: This uses 2 records per hour (2 × 7 × 20 = 280 per coder). The scenario gives 3 per hour.

4.29 FTE: Correct. Monthly output per coder = 3 × 7 × 20 = 420 records. FTEs needed = 1,800 ÷ 420 ≈ 4.29.

4.80 FTE: This does not follow from the given productivity figures. Recalculate the output per coder (420 records a month).

FTEs needed = workload volume ÷ output per FTE in the same period (productivity rate × productive hours × days).