AAPC chapter 1 exam|2023 LATEST UPDATE|GUARANTEED SUCCESS

Many coding professionals go on to find work as: Consultant A medical record contains information on all but what areas? Financial records Technicians who specialize in coding are called: Coding specialists EHR stands for: Electronic health record What type of provider goes through approximately 26.5 months of education and is licensed to practice medicine with the oversight of a physician? Physician Assistant (PA) The Medicare program is made up of several parts. Which part is most significant to coders working in physician offices and covers physician fees without the use of a private insurer? Part B The Medicare program is made up of several parts. Which part is affected by the Centers for Medicare and Medicaid Services' - hierarchal condition categories (CMS-HCC)? Part C What does CMS-HCC stand for? Centers for Medicare and Medicaid Services - Hierarchal Condition Category When coding an operative report, what action would NOT be recommended? Coding from the header without reading the body of the report Outpatient coders focus on learning which coding manuals? CPT, HCPCS Level II, and ICD-9-CM Volumes 1 and 2 If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient, who determines coverage? Medicare Administrative Contractor (MAC) The __ describes whether specific medical items, services, treatment procedures, or technologies are considered medically necessary under Medicare. National Coverage Determinations Manual National Coverage Determinations serve what purpose? To spell out CMS policies on when Medicare will pay for items or services MAC stands for what? Medicare Administrative Contractor Local Coverage Determinations are administered by __? Each regional MAC LCD's only have jurisdiction in their __ area. Regional ABN stands for Advance Beneficiary Notice When are providers responsible for obtaining an ABN for a service not considered medically necessary? Prior to providing a service or item to a beneficiary HIPAA stands for Health Insurance Portability and Accountability Act HIPAA was made into law in what year? 1996 A covered entity does NOT include Patient What is the definition of coding? Translating documentation into numerical/alphanumerical codes used to obtain reimbursement Who is responsible for enforcing he HIPAA security rule? OCR Healthcare providers are responsible for developing __ and policies and procedures regarding privacy in their practices. Notices of Privacy Practices A covered entity may obtain consent of the individual to use or disclose protected health information to carry out all but what of the following? For public use The minimum necessary rule is based on sound current practice that protected health information should not be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function. What does this mean? Providers should develop safeguards to prevent unauthorized access The minimum necessary rule applies to: Covered entities taking responsible steps HITECH provides a ___ day window which any violation not due willful neglect may be corrected without penalty? 30 HITECH was enacted as part of the American Recovery and Reinvestment Act in what year? 2009 Which of the following choices is NOT a benefit of an active compliance plan? Eliminates risk of an audit What will the scope of a compliance program depend on? Size and resources of the physician's practice HHS/OCR has investigated and resolved over __ cases by requiring changes in privacy practices and other corrective actions by the covered entities since its inception in 2003. 14,309 According to the OIG, internal monitoring and auditing should be performed by what means? Periodic audits Voluntary compliance programs also provide benefits by not only helping to prevent erroneous or ___, but also by showing that the physician practice is making additional good faith efforts to submit claims appropriately. Fraudulent claims