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Review Test Submissio n: Chapter 1 Quiz • Question 1 10 out of 10 points What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services within the coming year? Selected Answer: Correct Answer: Response Feedback: c. OIG Work Plan c. OIG Work Plan Rationale: Twice a year, the OIG releases a Work Plan outlining its priorities for the fiscal year ahead. Within the Work Plan, potential problem areas with claims submissions are listed and will be targeted with special scrutiny. • Question 2 0 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: Correct Answer: Response Feedback: d. muscle weakness b. fibromyalgia Rationale: According to the LCD, measurement of vitamin D levels is indicated for patients with fibromyalgia. • Question 3 Under HIPAA, what would be a policy requirement for “minimum necessary”? 10 out of 10 points Selected Answer: Correct Answer: a. Only individuals whose job requires it may have access to protected health information. a. Only individuals whose job requires it may have access to protected health information. S - The Marketplace to Buy and Sell your Study Material Downloaded by: gradebooster | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material AAPC ICD10 Physician Coding for CPC Preparation (All Exams) 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 4 0 out of 10 points Which act was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA) and affected privacy and security? Selected Answer: Correct Answer: Response Feedback: a. HIPAA b. HITECH Rationale: The Health Information Technology for Economic and Clinical Health Act (HITECH) was enacted as a part of the American Recovery and Reinvestment Act of 2009 (ARRA) to promote the adoption and meaningful use of health information technology. Portions of HITECH strengthen HIPAA rules by addressing privacy and security concerns associated with the electronic transmission of health information. • Question 5 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: Correct Answer: Response Feedback: d. ABN d. ABN 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 6 0 out of 10 points What document assists provider offices with the development of Compliance Manuals? Selected Answer: Correct Answer: Response Feedback: c. OIG Suggested Rules and Regulations a. OIG Compliance Plan Guidance 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 7 Who would NOT be considered a covered entity under HIPAA? Selected d. 10 out of 10 points Downloaded by: gradebooster | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material AAPC ICD10 Physician Coding for CPC Preparation (All Exams) Answer: Patients Correct Answer: Response Feedback: d. Patients 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 Select the TRUE statement regarding ABNs. 10 out of 10 points Selected Answer: Correct Answer: Response Feedback: a. ABNs may not be recognized by non-Medicare payers. a. ABNs may not be recognized by non-Medicare payers. 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 9 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: Correct Answer: Response Feedback: c. $100 or 25 percent c. $100 or 25 percent 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 10 Which statement describes a medically necessary service? 10 out of 10 points Selected Answer: Correct Answer: Response Feedback: b. Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. b. Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Rationale: Medical necessity is using the least radical services/procedure that allows for effective treatment of the patient’s complaint or condition. Thursday, September 21, 2017 7:47:13 PM MDT Review Test Submission: Chapter 1 Quiz

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