4/26/25, 9:25
AM
AAPC OFFICIAL CPC CERTIFICATION STUDY GUIDE NOTES EXAM
QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS
VERIFIED
Leave the first rating
Save
Terms in this set (156)
"hold harmless clause" * found in some non-Medicare health plan contracts
* prohibits billing to patient for anything beyond
deductibles and co-pays.
* more accurate payment of claims
A compliance plan may * fewer billing mistakes
offer several benefits, * improved documentation and more accurate coding
* less chance of violating self-referral and anti-
including:
kickback status
A healthcare clearing entity that processes nonstandard health
house is a information they receive from another entity
into a standard format
A key provision in HIPAA only the minimum necessary protected health
is the Minimum information should be shared to satisfy a
Necessary particular purpose.
requirement. this
means
A medically necessary least radical service/procedure that allows for
service is the effective treatment of the patients' complaint
or condition
A patient sustaining an Leg
injury to her great
saphenous vein would
have sustained
injury to which of
anatomical site?
1/
12
, 4/26/25, 9:25
AM
APC Ambulatory Payment Classification
ARRA American Recovery and Reinvestment Act (of 2009)
ASC Ambulatory Surgical Centers
Abuse consists of payment for items or services that are billed
by providers in error that should not be paid
for by Medicare.
An ABN protects the creating a paper trail that CMS requires before
provider's financial a provider can bill the patient for payment if
interest by Medicare denies coverage for the stated
service or procedure.
An entity that Clearinghouse
processes nonstandard
health information they
receive from
another entity into a
standard format is
considered what?
As a part of Health Care intent
Reform, the
Affordable Care Act of
2010 amended the
definition of fraud to
remove the __________
requirement
By statute, all work every 5 years
RVUs, must be
examined no less
often than
CF Coversion Factor - fixed dollar amount used to
translate the RVUs into fees
CMS Centers for Medicare and Medicaid
CMS developed Social Security Act
polices regarding
medical necessity
are based on
2/
12
AM
AAPC OFFICIAL CPC CERTIFICATION STUDY GUIDE NOTES EXAM
QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS
VERIFIED
Leave the first rating
Save
Terms in this set (156)
"hold harmless clause" * found in some non-Medicare health plan contracts
* prohibits billing to patient for anything beyond
deductibles and co-pays.
* more accurate payment of claims
A compliance plan may * fewer billing mistakes
offer several benefits, * improved documentation and more accurate coding
* less chance of violating self-referral and anti-
including:
kickback status
A healthcare clearing entity that processes nonstandard health
house is a information they receive from another entity
into a standard format
A key provision in HIPAA only the minimum necessary protected health
is the Minimum information should be shared to satisfy a
Necessary particular purpose.
requirement. this
means
A medically necessary least radical service/procedure that allows for
service is the effective treatment of the patients' complaint
or condition
A patient sustaining an Leg
injury to her great
saphenous vein would
have sustained
injury to which of
anatomical site?
1/
12
, 4/26/25, 9:25
AM
APC Ambulatory Payment Classification
ARRA American Recovery and Reinvestment Act (of 2009)
ASC Ambulatory Surgical Centers
Abuse consists of payment for items or services that are billed
by providers in error that should not be paid
for by Medicare.
An ABN protects the creating a paper trail that CMS requires before
provider's financial a provider can bill the patient for payment if
interest by Medicare denies coverage for the stated
service or procedure.
An entity that Clearinghouse
processes nonstandard
health information they
receive from
another entity into a
standard format is
considered what?
As a part of Health Care intent
Reform, the
Affordable Care Act of
2010 amended the
definition of fraud to
remove the __________
requirement
By statute, all work every 5 years
RVUs, must be
examined no less
often than
CF Coversion Factor - fixed dollar amount used to
translate the RVUs into fees
CMS Centers for Medicare and Medicaid
CMS developed Social Security Act
polices regarding
medical necessity
are based on
2/
12
