AAPC Official CPC Certification Study Guide
Notes Questions and Answers
1."hold harmless clause"
Answer * found in some non-Medicare health plan contracts
* prohibits billing to patient for anything beyond deductibles and co-pays.
2.A compliance plan may offer several benefits, including
Answer * more accurate payment of claims
* fewer billing mistakes
* improved documentation and more accurate coding
* less chance of violating self-referral and anti-kickback status
3.A healthcare clearing house is a
Answer entity that processes nonstandard health information they
receive from another entity into a standard format
4.A key provision in HIPAA is the Minimum Necessary requirement. this
means
Answer only the minimum necessary protected health information
should be shared to satisfy a particular purpose.
5.A medically necessary service is the
Answer least radical service/procedure that allows for effective
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,treatment of the patients' complaint or condition
6.A patient sustaining an injury to her great saphenous vein would
have sustained injury to which of anatomical site?
Answer Leg
7.APC
Answer Ambulatory Payment Classification
8.ARRA
Answer American Recovery and Reinvestment Act (of 2009)
9.ASC
Answer Ambulatory Surgical Centers
10.Abuse consists of
Answer payment for items or services that are billed by providers in
error that should not be paid for by Medicare.
11.An ABN protects the provider's financial interest by
Answer creating a paper trail that CMS requires before a provider can
bill the patient for payment if Medicare denies coverage for the stated
service or procedure.
12.An entity that processes nonstandard health information they receive
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, from another entity into a standard format is considered what?
Answer Clearinghouse
13.As a part of Health Care Reform, the Affordable Care Act of 2010
amended the definition of fraud to remove the requirement
Answer intent
14.By statute, all work RVUs, must be examined no less often than
Answer every 5 years
15.CF
Answer Coversion Factor - fixed dollar amount used to translate the
RVUs into fees
16.CMS
Answer Centers for Medicare and Medicaid
17.CMS developed polices regarding medical necessity are based on
regula- tions found in title XVIII, $1862(a) of the
Answer Social Security Act
18.CMS will accept the for either a "potentially
non=covered" service or for a statutorily excluded service
Answer CMS-R-131
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Notes Questions and Answers
1."hold harmless clause"
Answer * found in some non-Medicare health plan contracts
* prohibits billing to patient for anything beyond deductibles and co-pays.
2.A compliance plan may offer several benefits, including
Answer * more accurate payment of claims
* fewer billing mistakes
* improved documentation and more accurate coding
* less chance of violating self-referral and anti-kickback status
3.A healthcare clearing house is a
Answer entity that processes nonstandard health information they
receive from another entity into a standard format
4.A key provision in HIPAA is the Minimum Necessary requirement. this
means
Answer only the minimum necessary protected health information
should be shared to satisfy a particular purpose.
5.A medically necessary service is the
Answer least radical service/procedure that allows for effective
1/
26
,treatment of the patients' complaint or condition
6.A patient sustaining an injury to her great saphenous vein would
have sustained injury to which of anatomical site?
Answer Leg
7.APC
Answer Ambulatory Payment Classification
8.ARRA
Answer American Recovery and Reinvestment Act (of 2009)
9.ASC
Answer Ambulatory Surgical Centers
10.Abuse consists of
Answer payment for items or services that are billed by providers in
error that should not be paid for by Medicare.
11.An ABN protects the provider's financial interest by
Answer creating a paper trail that CMS requires before a provider can
bill the patient for payment if Medicare denies coverage for the stated
service or procedure.
12.An entity that processes nonstandard health information they receive
2/
26
, from another entity into a standard format is considered what?
Answer Clearinghouse
13.As a part of Health Care Reform, the Affordable Care Act of 2010
amended the definition of fraud to remove the requirement
Answer intent
14.By statute, all work RVUs, must be examined no less often than
Answer every 5 years
15.CF
Answer Coversion Factor - fixed dollar amount used to translate the
RVUs into fees
16.CMS
Answer Centers for Medicare and Medicaid
17.CMS developed polices regarding medical necessity are based on
regula- tions found in title XVIII, $1862(a) of the
Answer Social Security Act
18.CMS will accept the for either a "potentially
non=covered" service or for a statutorily excluded service
Answer CMS-R-131
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26
