AAPC CPC FINAL EXAM SCRIPT 2026
COMPLETE QUESTIONS AND CORRECT
ANSWERS GRADED A PLUS
◉ What form is provided to a patient to indicate a servicemay not be
covered by Medicare and the patient may be responsible for the
charges?:
A) LCD
B) CMS-1500
C) UB-04
D) ABN.
Answer: D (Rationale: An Advanced Beneficiary Notice (ABN) is used
when a Medicare beneficiary requests or agrees to receive a
procedure or service that Medicare may not cover. This form notifies
the patient of potential out of pocket costs for the patient.)
◉ Under HIPAA, what would be a policy requirement for "minimum
necessary"? "
A) Only individuals whose job requires it may have access to
protected health information.
B) Only the patient has access to his or her own protected health
information.
,C) Only the treating provider has access to protected health
information.
D) Anyone within the provider's office can have access to protected
health information..
Answer: A (Rationale: It is the responsibility of a covered entity to
develop and implement policies, best suited to its particular
circumstances to meet HIPAA requirements. As a policy
requirement, only those individuals whose job requires it may have
access to protected health information.)
◉ Which statement describes a medically necessary service? :
A) Performing a procedure/service based on cost to eliminate
wasteful services.
B) Using the least radical service/procedure that allows for effective
treatment of the patient's complaint or condition.
C) Using the closest facility to perform a service or procedure.
D) Using the appropriate course of treatment to fit within the
patient's lifestyle..
Answer: B (Rationale: Medical necessity is using the least radical
services/procedure that allows for effective treatment of the
patient's complaint or condition.)
◉ According to the example LCD from Novitas Solutions, which of
the following conditions is considered a systemic condition that may
result in the need for routine foot care? :
, A) arthritis
B) chronic venous insufficiency
C) hypertension
D) muscle weakness.
Answer: B (Rationale: According to the LCD, Chronic venous
insufficiency is a systemic condition that may result in the need for
routine foot care.)
◉ When presenting a cost estimate on an ABN for a potentially
noncovered service, the cost estimate should be within what range
of the actual cost?
A) $25 or 10 percent
B) $100 or 10 percent
C) $100 or 25 percent
D) An exact amount.
Answer: C (Rationale: CMS instructions stipulate, "Notifiers must
make a good faith effort to insert a reasonable estimate...the
estimate should be within $100 or 25 percent of the actual costs,
whichever is greater.")
◉ Which act was enacted as part of the American Recovery and
Reinvestment Act of 2009 (ARRA) and affected privacy and security?
:
A) HIPAA
COMPLETE QUESTIONS AND CORRECT
ANSWERS GRADED A PLUS
◉ What form is provided to a patient to indicate a servicemay not be
covered by Medicare and the patient may be responsible for the
charges?:
A) LCD
B) CMS-1500
C) UB-04
D) ABN.
Answer: D (Rationale: An Advanced Beneficiary Notice (ABN) is used
when a Medicare beneficiary requests or agrees to receive a
procedure or service that Medicare may not cover. This form notifies
the patient of potential out of pocket costs for the patient.)
◉ Under HIPAA, what would be a policy requirement for "minimum
necessary"? "
A) Only individuals whose job requires it may have access to
protected health information.
B) Only the patient has access to his or her own protected health
information.
,C) Only the treating provider has access to protected health
information.
D) Anyone within the provider's office can have access to protected
health information..
Answer: A (Rationale: It is the responsibility of a covered entity to
develop and implement policies, best suited to its particular
circumstances to meet HIPAA requirements. As a policy
requirement, only those individuals whose job requires it may have
access to protected health information.)
◉ Which statement describes a medically necessary service? :
A) Performing a procedure/service based on cost to eliminate
wasteful services.
B) Using the least radical service/procedure that allows for effective
treatment of the patient's complaint or condition.
C) Using the closest facility to perform a service or procedure.
D) Using the appropriate course of treatment to fit within the
patient's lifestyle..
Answer: B (Rationale: Medical necessity is using the least radical
services/procedure that allows for effective treatment of the
patient's complaint or condition.)
◉ According to the example LCD from Novitas Solutions, which of
the following conditions is considered a systemic condition that may
result in the need for routine foot care? :
, A) arthritis
B) chronic venous insufficiency
C) hypertension
D) muscle weakness.
Answer: B (Rationale: According to the LCD, Chronic venous
insufficiency is a systemic condition that may result in the need for
routine foot care.)
◉ When presenting a cost estimate on an ABN for a potentially
noncovered service, the cost estimate should be within what range
of the actual cost?
A) $25 or 10 percent
B) $100 or 10 percent
C) $100 or 25 percent
D) An exact amount.
Answer: C (Rationale: CMS instructions stipulate, "Notifiers must
make a good faith effort to insert a reasonable estimate...the
estimate should be within $100 or 25 percent of the actual costs,
whichever is greater.")
◉ Which act was enacted as part of the American Recovery and
Reinvestment Act of 2009 (ARRA) and affected privacy and security?
:
A) HIPAA
