Registered Health Information Technician (RHIT) Practice Exam

When a facility's Medicare case-mix index has decreased, conducting a focused audit is essential to check for potential coding errors. A focused audit specifically targets areas of concern or topics that may have contributed to the decline in the case-mix index. This type of audit allows for a more in-depth examination of selected records, ensuring that the coding accurately reflects the services provided and the complexity of the patients treated.

The focus is critical here because it helps in identifying discrepancies or errors that might have affected the case-mix index, which could result from misreported diagnoses or procedures. By isolating and evaluating these specific elements, coders and auditors can pinpoint errors that, once corrected, may help improve the facility's reimbursement and accurate representation of patient case complexity.

In contrast, a comprehensive audit would evaluate all areas without a specific focus, potentially being less efficient in addressing the immediate issue of the decreased index. A random audit lacks direction and could miss the specific errors contributing to the decline, while a peer review is more qualitative and typically involves discussions around performance rather than a strict audit of coding accuracy. Thus, the focused audit is the most appropriate approach in this scenario.