AAPC CPC Chapter 1 Questions and
Answers 100% Pass
Medical coding ✔✔process of translating a healthcare provider's documentation of a patient
encounter into a series of numeric or alphanumeric codes
Health information coders, medical record coders, coder/abstractors, coding specialists
✔✔coders who specialize in coding inpatient hospital services
MS-DRG ✔✔Medical Severity-Diagnosis Related Groups
MS-DRG are used to: ✔✔determine the amount the hospital will be reimbursed if the patient is
covered by Medicare or other insurance programs using the MS-DRG system
Cancer (or tumor) registrars ✔✔maintain facility, regional, and national databases of cancer
patients
EHR ✔✔electronic health record
, Other roles coders can have: ✔✔consultants, educators, medical auditors
Outpatient coders ✔✔use CPT, HCPCS Level II, and ICD-10-CM codes; work in provider
offices, outpatient clinics, and facility outpatient departments; also use Ambulatory Payment
Classifications (APCs); have more interaction with providers
Inpatient coders ✔✔use ICD-10-CM and ICD-10-PCS codes; also use MS-DRGs for
reimbursement; have less interation directly with providers
Remittance advice (RA) / Explanation of Benefits (EOB) ✔✔explains the payer's determination
in payment
Scope of practice ✔✔practice guidelines for each level of a provider individually dictated by
states
Mid-level Provider (MLP) ✔✔include physician assistants (PA) and nurse practitioners (NP);
aka physician extenders
Answers 100% Pass
Medical coding ✔✔process of translating a healthcare provider's documentation of a patient
encounter into a series of numeric or alphanumeric codes
Health information coders, medical record coders, coder/abstractors, coding specialists
✔✔coders who specialize in coding inpatient hospital services
MS-DRG ✔✔Medical Severity-Diagnosis Related Groups
MS-DRG are used to: ✔✔determine the amount the hospital will be reimbursed if the patient is
covered by Medicare or other insurance programs using the MS-DRG system
Cancer (or tumor) registrars ✔✔maintain facility, regional, and national databases of cancer
patients
EHR ✔✔electronic health record
, Other roles coders can have: ✔✔consultants, educators, medical auditors
Outpatient coders ✔✔use CPT, HCPCS Level II, and ICD-10-CM codes; work in provider
offices, outpatient clinics, and facility outpatient departments; also use Ambulatory Payment
Classifications (APCs); have more interaction with providers
Inpatient coders ✔✔use ICD-10-CM and ICD-10-PCS codes; also use MS-DRGs for
reimbursement; have less interation directly with providers
Remittance advice (RA) / Explanation of Benefits (EOB) ✔✔explains the payer's determination
in payment
Scope of practice ✔✔practice guidelines for each level of a provider individually dictated by
states
Mid-level Provider (MLP) ✔✔include physician assistants (PA) and nurse practitioners (NP);
aka physician extenders
