AAPC OFFICIAL CPC
CERTIFICATION EXAM
PRACTICE QUESTIONS AND
VERIFIED SOLUTIONS
"Hold harmless clause"
* found in some non-medicare health plan contracts
* prohibits billing to patient for anything beyond deductibles and co-pays.
A compliance plan may offer several benefits, including:
* more accurate payment of claims
* fewer billing mistakes
* improved documentation and more accurate coding
* less chance of violating self-referral and anti-kickback status
A healthcare clearing house is a
Entity that processes nonstandard health information they receive from another
entity into a standard format
A key provision in hipaa is the minimum necessary requirement. This means
Only the minimum necessary protected health information should be shared to
satisfy a particular purpose.
A medically necessary service is the
Least radical service/procedure that allows for effective treatment of the patients'
complaint or condition
A patient sustaining an injury to her great saphenous vein would have
sustained injury to which of anatomical site?
Leg
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 provider's financial interest by
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.
An entity that processes nonstandard health information they receive from
another entity into a standard format is considered what?
Clearinghouse
As a part of health care reform, the affordable care act of 2010 amended the
definition of fraud to remove the __________ requirement
Intent
By statute, all work rvus, must be examined no less often than
Every 5 years
Cf
Coversion factor - fixed dollar amount used to translate the rvus into fees
Cms
Centers for medicare and medicaid
Cms developed polices regarding medical necessity are based on regulations
found in title xviii, $1862(a) of the
Social security act
Cms will accept the ____________ for either a "potentially non=covered"
service or for a statutorily excluded service
Cms-r-131
Cms-r-131
Abn form
or
advance beneficiary notice which explains to the patient why medicare may deny the
particular service or procedure.
Cpt
Current procedural terminology
Cy 2013 conversion factor
CERTIFICATION EXAM
PRACTICE QUESTIONS AND
VERIFIED SOLUTIONS
"Hold harmless clause"
* found in some non-medicare health plan contracts
* prohibits billing to patient for anything beyond deductibles and co-pays.
A compliance plan may offer several benefits, including:
* more accurate payment of claims
* fewer billing mistakes
* improved documentation and more accurate coding
* less chance of violating self-referral and anti-kickback status
A healthcare clearing house is a
Entity that processes nonstandard health information they receive from another
entity into a standard format
A key provision in hipaa is the minimum necessary requirement. This means
Only the minimum necessary protected health information should be shared to
satisfy a particular purpose.
A medically necessary service is the
Least radical service/procedure that allows for effective treatment of the patients'
complaint or condition
A patient sustaining an injury to her great saphenous vein would have
sustained injury to which of anatomical site?
Leg
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 provider's financial interest by
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.
An entity that processes nonstandard health information they receive from
another entity into a standard format is considered what?
Clearinghouse
As a part of health care reform, the affordable care act of 2010 amended the
definition of fraud to remove the __________ requirement
Intent
By statute, all work rvus, must be examined no less often than
Every 5 years
Cf
Coversion factor - fixed dollar amount used to translate the rvus into fees
Cms
Centers for medicare and medicaid
Cms developed polices regarding medical necessity are based on regulations
found in title xviii, $1862(a) of the
Social security act
Cms will accept the ____________ for either a "potentially non=covered"
service or for a statutorily excluded service
Cms-r-131
Cms-r-131
Abn form
or
advance beneficiary notice which explains to the patient why medicare may deny the
particular service or procedure.
Cpt
Current procedural terminology
Cy 2013 conversion factor
