AAPC CPC exam prep Compliance and
Regulatory (Newest Update)
Questions and Detailed Answers 100%
Verified Correct (Grade A+) Already
Passed
What is medical necessity?:
A) Services to a Medicare beneficiary that are billed for unreasonable and unnecessary
treatment.
B) The most radical service/procedure that allows for effective treatment of the
patient's complaint or condition.
C) Something insurance plans do not care about.
D) Relates to whether a procedure or service is considered appropriate in a given
circumstance. - correct answer D
What is not a common reason Medicare may deny a procedure or service?:
,A) Patient's condition
B) Frequently proposed
C) Covered service
D) Experimental - correct answer C
Under the Privacy Rule, the minimum necessary standard does NOT apply to what type
of disclosures?:
A) Uses or disclosures to drug companies.
B) Disclosures to or requests by family members.
C) Disclosures to the individual who is the subject of the information.
D) Uses or disclosures to insurance companies. - correct answer C
, Which is not one of the seven key components of an internal compliance plan?:
A) Develop open lines of communication.
B) Conduct training but not perform education on practice standards and procedures.
C) Enforce disciplinary standards through well-publicized guidelines.
D) Conduct internal monitoring and auditing through the performance of periodic
audits. - correct answer B
The ____describes whether specific medical items, services, treatment procedures or
technologies are considered medically necessary under Medicare:
A) National Coverage Determinations Manual
B) Internet Only Manual
C) Medicare Severity-Diagnosis Related Groups (MS-DRG)
Regulatory (Newest Update)
Questions and Detailed Answers 100%
Verified Correct (Grade A+) Already
Passed
What is medical necessity?:
A) Services to a Medicare beneficiary that are billed for unreasonable and unnecessary
treatment.
B) The most radical service/procedure that allows for effective treatment of the
patient's complaint or condition.
C) Something insurance plans do not care about.
D) Relates to whether a procedure or service is considered appropriate in a given
circumstance. - correct answer D
What is not a common reason Medicare may deny a procedure or service?:
,A) Patient's condition
B) Frequently proposed
C) Covered service
D) Experimental - correct answer C
Under the Privacy Rule, the minimum necessary standard does NOT apply to what type
of disclosures?:
A) Uses or disclosures to drug companies.
B) Disclosures to or requests by family members.
C) Disclosures to the individual who is the subject of the information.
D) Uses or disclosures to insurance companies. - correct answer C
, Which is not one of the seven key components of an internal compliance plan?:
A) Develop open lines of communication.
B) Conduct training but not perform education on practice standards and procedures.
C) Enforce disciplinary standards through well-publicized guidelines.
D) Conduct internal monitoring and auditing through the performance of periodic
audits. - correct answer B
The ____describes whether specific medical items, services, treatment procedures or
technologies are considered medically necessary under Medicare:
A) National Coverage Determinations Manual
B) Internet Only Manual
C) Medicare Severity-Diagnosis Related Groups (MS-DRG)
