AAPC CPC Chapter 1 Test with Answers
1. C (Rationale: Twice a What document is referenced to when looking for
year, the OIG releases potential problem areas identified by the govern-
a Work Plan outlining ment indicating scrutiny of the services within the
its priorities for the fis- coming year?:
cal year ahead. Within A) OIG Compliance Plan Guidance
the Work Plan, poten- B) OIG Security Summary
tial problem areas with C) OIG Work Plan
claims submissions are D) OIG Investigation Plan
listed and will be target-
ed with special scruti-
ny.)
2. D (Rationale: An Ad- What form is provided to a patient to indicate a
vanced Beneficiary No- service may not be covered by Medicare and the
tice (ABN) is used when patient may be responsible for the charges?:
a Medicare beneficiary A) LCD
requests or agrees to B) CMS-1500
receive a procedure or C) UB-04
service that Medicare D) ABN
may not cover. This
form notifies the patient
of potential out of pock-
et costs for the patient.)
3. A (Rationale: It is the Under HIPAA, what would be a policy requirement
responsibility of a cov- for "minimum necessary"? "
ered entity to develop A) Only individuals whose job requires it may have
and implement policies, access to protected health information.
best suited to its partic- B) Only the patient has access to his or her own
ular circumstances to protected health information.
meet HIPAA require- C) Only the treating provider has access to protect-
ments. As a policy re- ed health information.
quirement, only those D) Anyone within the provider's office can have
individuals whose job access to protected health information.
requires it may have ac-
cess to protected health
information.)
4.
, AAPC CPC Chapter 1 Test with Answers
B (Rationale: Med- Which statement describes a medically necessary
ical necessity is using service? :
the least radical ser- A) Performing a procedure/service based on cost
vices/procedure that al- to eliminate wasteful services.
lows for effective treat- B) Using the least radical service/procedure that
ment of the patient's allows for effective treatment of the patient's com-
complaint or condition.) plaint or condition.
C) Using the closest facility to perform a service or
procedure.
D) Using the appropriate course of treatment to fit
within the patient's lifestyle.
5. C (Rationale: According According to the example LCD from Novitas Solu-
to the LCD, Chronic ve- tions, which of the following conditions is consid-
nous insufficiency is a ered a systemic condition that may result in the
systemic condition that need for routine foot care? :
may result in the need A) arthritis
for routine foot care.) B) chronic venous insufficiency
C) hypertension
D) muscle weakness
6. C (Rationale: CMS When presenting a cost estimate on an ABN for a
instructions stipulate, potentially noncovered service, the cost estimate
"Notifiers must make should be within what range of the actual cost?
a good faith effort A) $25 or 10 percent
to insert a reasonable B) $100 or 10 percent
estimate...the estimate C) $100 or 25 percent
should be within $100 D) An exact amount
or 25 percent of the ac-
tual costs, whichever is
greater.")
7. B Which act was enacted as part of the American
Recovery and Reinvestment Act of 2009 (ARRA)
and affected privacy and security? :
A) HIPAA
B) HITECH
C) SSA
D) PPACA
1. C (Rationale: Twice a What document is referenced to when looking for
year, the OIG releases potential problem areas identified by the govern-
a Work Plan outlining ment indicating scrutiny of the services within the
its priorities for the fis- coming year?:
cal year ahead. Within A) OIG Compliance Plan Guidance
the Work Plan, poten- B) OIG Security Summary
tial problem areas with C) OIG Work Plan
claims submissions are D) OIG Investigation Plan
listed and will be target-
ed with special scruti-
ny.)
2. D (Rationale: An Ad- What form is provided to a patient to indicate a
vanced Beneficiary No- service may not be covered by Medicare and the
tice (ABN) is used when patient may be responsible for the charges?:
a Medicare beneficiary A) LCD
requests or agrees to B) CMS-1500
receive a procedure or C) UB-04
service that Medicare D) ABN
may not cover. This
form notifies the patient
of potential out of pock-
et costs for the patient.)
3. A (Rationale: It is the Under HIPAA, what would be a policy requirement
responsibility of a cov- for "minimum necessary"? "
ered entity to develop A) Only individuals whose job requires it may have
and implement policies, access to protected health information.
best suited to its partic- B) Only the patient has access to his or her own
ular circumstances to protected health information.
meet HIPAA require- C) Only the treating provider has access to protect-
ments. As a policy re- ed health information.
quirement, only those D) Anyone within the provider's office can have
individuals whose job access to protected health information.
requires it may have ac-
cess to protected health
information.)
4.
, AAPC CPC Chapter 1 Test with Answers
B (Rationale: Med- Which statement describes a medically necessary
ical necessity is using service? :
the least radical ser- A) Performing a procedure/service based on cost
vices/procedure that al- to eliminate wasteful services.
lows for effective treat- B) Using the least radical service/procedure that
ment of the patient's allows for effective treatment of the patient's com-
complaint or condition.) plaint or condition.
C) Using the closest facility to perform a service or
procedure.
D) Using the appropriate course of treatment to fit
within the patient's lifestyle.
5. C (Rationale: According According to the example LCD from Novitas Solu-
to the LCD, Chronic ve- tions, which of the following conditions is consid-
nous insufficiency is a ered a systemic condition that may result in the
systemic condition that need for routine foot care? :
may result in the need A) arthritis
for routine foot care.) B) chronic venous insufficiency
C) hypertension
D) muscle weakness
6. C (Rationale: CMS When presenting a cost estimate on an ABN for a
instructions stipulate, potentially noncovered service, the cost estimate
"Notifiers must make should be within what range of the actual cost?
a good faith effort A) $25 or 10 percent
to insert a reasonable B) $100 or 10 percent
estimate...the estimate C) $100 or 25 percent
should be within $100 D) An exact amount
or 25 percent of the ac-
tual costs, whichever is
greater.")
7. B Which act was enacted as part of the American
Recovery and Reinvestment Act of 2009 (ARRA)
and affected privacy and security? :
A) HIPAA
B) HITECH
C) SSA
D) PPACA
