AAPC Exam 1 The Business of Medicine
UPDATED QUESTIONS AND CORRECT
ANSWERS
The OIG recommends that provider practices enforce disciplinary actions through well
publicized compliance guidelines to ensure actions that are ______. - CORRECT
ANSWER Consistent and appropriate
Rationale: The OIG recommends that a provider practice's enforcement and disciplinary
mechanisms ensure that violations of the practice's compliance policies will result in
consistent and appropriate sanctions, including the possibility of termination, against the
offending individual.
Which provider is NOT a mid-level provider? - CORRECT
ANSWER Anesthesiologist
Rationale: Mid-level providers include physician assistants (PA) and nurse practitioners (NP).
An anesthesiologist is a physician. Mid-level providers are also known as physician extenders
because they extend the work of a physician.
LCDs only have jurisdiction in their ____. - CORRECT ANSWER Region
Rationale: LCDs only have jurisdiction within their region.
Which type of information is NOT maintained in a medical record? - CORRECT
ANSWER Financial records
Rationale: Every time a patient receives health care, a record is maintained of the
observations, medical or surgical interventions and treatment outcomes. Administrative data,
such as financial records, should not be included in the medical record or provided in
response to a subpoena or request for health records, unless financial records are specifically
stated on the subpoena request.
, What type of insurance is Medicare Part D? - CORRECT ANSWER Prescription drug
coverage available to all Medicare beneficiaries.
Rationale: Medicare Part D is a prescription drug program available to all Medicare
beneficiaries for a fee. Private companies approved by Medicare provide the coverage.
A covered entity may obtain consent from an individual to use or disclose protected health
information to carry out all of the following EXCEPT what? - CORRECT
ANSWER Research
Rationale: A covered entity may obtain consent of the individual to use or disclose protected
health information to carry out treatment, payment or healthcare operations.
What is the definition of medical coding? - CORRECT ANSWER Translating
documentation into numerical/alphanumerical codes used to obtain reimbursement.
Rationale: Medical coding is the process of translating a healthcare provider's documentation
of a patient encounter into a series of numeric or alphanumeric codes.
What is the purpose of National Coverage Determinations? - CORRECT ANSWER To
explain CMS policies on when Medicare will pay for items or services.
Rationale: National Coverage Determinations (NCD) explain CMS policies on when
Medicare will pay for items or services.
Which of the following is NOT a component of the MIPS program? - CORRECT
ANSWER Readmission Rates
Rationale: The four components of the MIPS program are Quality, Promoting
Interoperability, Improvement Activities and Cost. While readmission rates can impact cost,
the overall cost is a metric considered in the MIPS program.
UPDATED QUESTIONS AND CORRECT
ANSWERS
The OIG recommends that provider practices enforce disciplinary actions through well
publicized compliance guidelines to ensure actions that are ______. - CORRECT
ANSWER Consistent and appropriate
Rationale: The OIG recommends that a provider practice's enforcement and disciplinary
mechanisms ensure that violations of the practice's compliance policies will result in
consistent and appropriate sanctions, including the possibility of termination, against the
offending individual.
Which provider is NOT a mid-level provider? - CORRECT
ANSWER Anesthesiologist
Rationale: Mid-level providers include physician assistants (PA) and nurse practitioners (NP).
An anesthesiologist is a physician. Mid-level providers are also known as physician extenders
because they extend the work of a physician.
LCDs only have jurisdiction in their ____. - CORRECT ANSWER Region
Rationale: LCDs only have jurisdiction within their region.
Which type of information is NOT maintained in a medical record? - CORRECT
ANSWER Financial records
Rationale: Every time a patient receives health care, a record is maintained of the
observations, medical or surgical interventions and treatment outcomes. Administrative data,
such as financial records, should not be included in the medical record or provided in
response to a subpoena or request for health records, unless financial records are specifically
stated on the subpoena request.
, What type of insurance is Medicare Part D? - CORRECT ANSWER Prescription drug
coverage available to all Medicare beneficiaries.
Rationale: Medicare Part D is a prescription drug program available to all Medicare
beneficiaries for a fee. Private companies approved by Medicare provide the coverage.
A covered entity may obtain consent from an individual to use or disclose protected health
information to carry out all of the following EXCEPT what? - CORRECT
ANSWER Research
Rationale: A covered entity may obtain consent of the individual to use or disclose protected
health information to carry out treatment, payment or healthcare operations.
What is the definition of medical coding? - CORRECT ANSWER Translating
documentation into numerical/alphanumerical codes used to obtain reimbursement.
Rationale: Medical coding is the process of translating a healthcare provider's documentation
of a patient encounter into a series of numeric or alphanumeric codes.
What is the purpose of National Coverage Determinations? - CORRECT ANSWER To
explain CMS policies on when Medicare will pay for items or services.
Rationale: National Coverage Determinations (NCD) explain CMS policies on when
Medicare will pay for items or services.
Which of the following is NOT a component of the MIPS program? - CORRECT
ANSWER Readmission Rates
Rationale: The four components of the MIPS program are Quality, Promoting
Interoperability, Improvement Activities and Cost. While readmission rates can impact cost,
the overall cost is a metric considered in the MIPS program.
