CPC Final Exam Prep Questions Corrected With Rationales

CPC Final Exam Prep Questions Corrected With Rationales Question 1 10 out of 10 points What form is provided to a patient to indicate a service may not be covered by Medicare and the patient may be responsible for the charges? Selected Answer: d. ABN Correct Answer: d. ABN Response Feedback: 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.  Question 2 10 out of 10 points Which statement describes a medically necessary service? Selected Answer: b. Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Correct Answer: b. Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Response Feedback: Rationale: Medical necessity is using the least radical services/procedure that allows for effective treatment of the patient’s complaint or condition.  Question 3 10 out of 10 points What document assists provider offices with the development of Compliance Manuals? Selected Answer: a. OIG Compliance Plan Guidance Correct Answer: a. OIG Compliance Plan Guidance Response Feedback: Rationale: The OIG has offered compliance program guidance to form the basis of a voluntary compliance program for physician offices. Although this was released in October 2000, it is still active compliance guidance today.  Question 4 10 out of 10 points Under HIPAA, what would be a policy requirement for “minimum necessary”? Selected Answer: a. Only individuals whose job requires it may have access to protected health information. Correct Answer: a. Only individuals whose job requires it may have access to protected health information. Response Feedback: 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.  Question 5 10 out of 10 points According to the example LCD from Novitas Solutions, measurement of vitamin D levels is indicated for patients with which condition? Selected Answer: b. fibromyalgi a Correct Answer: b. fibromyalgi a Response Feedback: Rationale: According to the LCD, measurement of vitamin D levels is indicated for patients with fibromyalgia.  Question 6 10 out of 10 points Select the TRUE statement regarding ABNs. Selected Answer: a. ABNs may not be recognized by non-Medicare payers. Correct Answer: a. ABNs may not be recognized by non-Medicare payers. Response Feedback: Rationale: ABNs may not be recognized by non-Medicare payers. Providers should review their contracts to determine which payers will accept an ABN for services not covered.  Question 7 10 out of 10 points Who would NOT be considered a covered entity under HIPAA? Selected Answer: d. Patients Correct Answer: d. Patients Response Feedback: Rationale: Covered entities in relation to HIPAA include Health Care Providers, Health Plans, and Health Care Clearinghouses. The patient is not considered a covered entity although it is the patient’s data that is protected.  Question 8 10 out of 10 points 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? Selected Answer: c. $100 or 25 percent Correct Answer: c. $100 or 25 percent Response Feedback: 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.”  Question 9 10 out of 10 points Which act was enacted as part of the American Recovery and Reinvestment Act of 2009