AAPC - CPC Chapter 1: The Business of Medicine -
Final | 134 Questions with 100% Correct Answers
Under HIPAA, what would be a policy requirement for minimum necessary? Correct Answer:
Only individuals whose job requires it may have access to protected health information
Which Act was enacted as part of the American Recovery and Reinvestment Act (ARRA) of
2009 and affected privacy and security? Correct Answer: HITECH
What document assists provider offices with the development of compliance manuals? Correct
Answer: OIG Compliance Plan Guidance
What type of profession, other than coding, might skilled coders enter? Correct Answer:
Consultants, educators, and medical auditors
What is the difference between outpatient and inpatient coding? Correct Answer: Inpatient
coders use ICD-10-CM and ICD-10-PCS
What are the different parts of Medicare? Correct Answer: Parts A,B,C, and D
Evaluation and Management (E/M) services are often provided and documented in a standard
SOAP format. What does SOAP represent? Correct Answer: Subjective
Objective
Assessment
Plan
What are 5 tips for coding operative reports? Correct Answer: Diagnosis code reporting
Start with procedures listed
Look for key words
Highlight unfamiliar words
Read the body
What is medical necessity? Correct Answer: Relates to whether a procedure or service is
considered appropriate in a given circumstance
What is NOT a common reason Medicare may deny a procedure or service? Correct Answer:
Covered service
Which is NOT one of the seven key components of an internal compliance plan? Correct
Answer: Conduct training but not perform education on practice standards and procedures
What is the value of a remittance advice? Correct Answer: It states what will be paid and why
any changes to charges were made
, The ____________ describes whether specific medical items, services, treatment procedures or
technologies are considered medically necessary under Medicare? Correct Answer: National
Coverage Determinations Manual
Which option is NOT a covered entity under HIPAA? Correct Answer: Workers' Compensation
What type of insurance is Medicare Part D? Correct Answer: Prescription drug coverage
available to all Medicare beneficiaries
According to AAPC's Code of Ethics, an AAPC member shall use only _______ and _______
means in all professional dealings? Correct Answer: Legal and ethical
Voluntary compliance programs also provide benefits by not only helping to prevent erroneous
or _________, but also by showing that the provider is making additional good faith efforts to
submit claims appropriately? Correct Answer: Fraudulent claims
A covered entity may obtain consent from an individual to use or disclose protected health
information to carry out all of the following EXCEPT what? Correct Answer: Research
Healthcare providers are responsible for developing ___________ and policies and procedures
regarding privacy in their practices? Correct Answer: Notice of Privacy Practices
EHR Correct Answer: Electronic health record
If an NCD does not exist for a particular service/procedure performed on a Medicare patient,
who determines coverage? Correct Answer: Medicare Administrative Contractor (MAC)
ABN Correct Answer: Advance Beneficiary Notice
Professionals who specialize in coding are called? Correct Answer: Coding specialists
According to OIG, internal monitoring and auditing should be performed by what means?
Correct Answer: Periodic audits
AAPC credentialed coders have proven mastery of what information? Correct Answer: Code
sets
Evaluation and Management principles
Documentation guidelines
When are providers responsible for obtaining an ABN for a service NOT considered medically
necessary? Correct Answer: Prior to providing a service or item to a beneficiary
How many components are included in an effective compliance plan? Correct Answer: 7
MAC Correct Answer: Medicare Administrative Contractor
Final | 134 Questions with 100% Correct Answers
Under HIPAA, what would be a policy requirement for minimum necessary? Correct Answer:
Only individuals whose job requires it may have access to protected health information
Which Act was enacted as part of the American Recovery and Reinvestment Act (ARRA) of
2009 and affected privacy and security? Correct Answer: HITECH
What document assists provider offices with the development of compliance manuals? Correct
Answer: OIG Compliance Plan Guidance
What type of profession, other than coding, might skilled coders enter? Correct Answer:
Consultants, educators, and medical auditors
What is the difference between outpatient and inpatient coding? Correct Answer: Inpatient
coders use ICD-10-CM and ICD-10-PCS
What are the different parts of Medicare? Correct Answer: Parts A,B,C, and D
Evaluation and Management (E/M) services are often provided and documented in a standard
SOAP format. What does SOAP represent? Correct Answer: Subjective
Objective
Assessment
Plan
What are 5 tips for coding operative reports? Correct Answer: Diagnosis code reporting
Start with procedures listed
Look for key words
Highlight unfamiliar words
Read the body
What is medical necessity? Correct Answer: Relates to whether a procedure or service is
considered appropriate in a given circumstance
What is NOT a common reason Medicare may deny a procedure or service? Correct Answer:
Covered service
Which is NOT one of the seven key components of an internal compliance plan? Correct
Answer: Conduct training but not perform education on practice standards and procedures
What is the value of a remittance advice? Correct Answer: It states what will be paid and why
any changes to charges were made
, The ____________ describes whether specific medical items, services, treatment procedures or
technologies are considered medically necessary under Medicare? Correct Answer: National
Coverage Determinations Manual
Which option is NOT a covered entity under HIPAA? Correct Answer: Workers' Compensation
What type of insurance is Medicare Part D? Correct Answer: Prescription drug coverage
available to all Medicare beneficiaries
According to AAPC's Code of Ethics, an AAPC member shall use only _______ and _______
means in all professional dealings? Correct Answer: Legal and ethical
Voluntary compliance programs also provide benefits by not only helping to prevent erroneous
or _________, but also by showing that the provider is making additional good faith efforts to
submit claims appropriately? Correct Answer: Fraudulent claims
A covered entity may obtain consent from an individual to use or disclose protected health
information to carry out all of the following EXCEPT what? Correct Answer: Research
Healthcare providers are responsible for developing ___________ and policies and procedures
regarding privacy in their practices? Correct Answer: Notice of Privacy Practices
EHR Correct Answer: Electronic health record
If an NCD does not exist for a particular service/procedure performed on a Medicare patient,
who determines coverage? Correct Answer: Medicare Administrative Contractor (MAC)
ABN Correct Answer: Advance Beneficiary Notice
Professionals who specialize in coding are called? Correct Answer: Coding specialists
According to OIG, internal monitoring and auditing should be performed by what means?
Correct Answer: Periodic audits
AAPC credentialed coders have proven mastery of what information? Correct Answer: Code
sets
Evaluation and Management principles
Documentation guidelines
When are providers responsible for obtaining an ABN for a service NOT considered medically
necessary? Correct Answer: Prior to providing a service or item to a beneficiary
How many components are included in an effective compliance plan? Correct Answer: 7
MAC Correct Answer: Medicare Administrative Contractor
