AAPC CPC UPDATED EXAM QUESTIONS AND ANSWERS
SURE A+
✔✔A (Rationale: ABNs may not be recognized by non-Medicare payers. Providers
should review their contracts to determine which payers will accept an ABN for services
not covered.) - ✔✔Select the TRUE statement regarding ABNs.
A) ABNs may not be recognized by non-Medicare payers.
B) ABNs must be signed for emergency or urgent care.
C) ABNs are not required to include an estimate cost for the service.
D) ABNs should be routinely signed by Medicare Beneficiaries in case Medicare doesn't
cover a service.
✔✔E (Rationale: Covered entities in relation to HIPAA include Health Care Providers,
Health Plans, and Health Care Clearinghouses. The patient is not considered a covered
entity although it is the patient's data that is protected.) - ✔✔Who would NOT be
considered a covered entity under HIPAA?
A) Doctors
C) HMOs
D) Clearinghouses
E) Patients
✔✔C - ✔✔What type of profession, other than coding, might skilled coders enter?:
A) Physicians, insurance carriers, nurses
B) Front desk personnel, HR dept
C) Consultants, educators, medical auditors
D) None of the above
✔✔D - ✔✔What is the difference between outpatient and inpatient coding?:
A) Outpatient coders use ICD-10-CM and ICD-10-PCS.
B) Outpatient coders only focuse on hospital services and Inpatient coders focuse on
physician services.
C) Inpatient coders have more interaction than Outpatient coders.
D) Inpatient coders use ICD-10-CM and ICD-10-PCS.
✔✔C - ✔✔What is a mid-level provider?
A) Non-licensed PAs
B) Physician withholder
C) Mid-level providers include physician assistants (PA) and nurse practitioners (NP).
D) NPs with Bachelor's Degree
✔✔B - ✔✔What are the different parts of Medicare?
A) Part A, B, D
B) Part A, B, C, D
C) Part E, F, G, H
D) Part A and B
, ✔✔A - ✔✔Evaluation and management (E/M) services are often provided and
documented in a standard format. One such format is SOAP notes. What does SOAP
represent?
A) Subjective, Objective, Assessment, Plan
B) Statement, Observation, Action, Prepare
C) Symptoms, Objective, Auscultation, Percussion
D) Subjective, Observation, Action, Plan
✔✔B - ✔✔What are five tips for coding operative (op) reports?
A) Look for key words, Ignore unfamiliar words, Skip the body, Ignore pathology reports,
Only code procedures from the header
B) Diagnosis code reporting, Start with the procedures listed, Look for key words,
Highlight unfamiliar words, Read the body
C) Highlight familiar words, Look for key words, Read the body, Only code what you
have highlighted, Code procedure only
D) Read the headers only, Look for key words, Highlight familiar words, Ignore
pathology report, Code diagnosis only
✔✔D - ✔✔What is medical necessity?:
A) Services to a Medicare beneficiary that are billed for unreasonable and unnecessary
treatment.
B) The most radical service/procedure that allows for effective treatment of the patient's
complaint or condition.
C) Something insurance plans do not care about.
D) Relates to whether a procedure or service is considered appropriate in a given
circumstance.
✔✔C - ✔✔What is not a common reason Medicare may deny a procedure or service?:
A) Patient's condition
B) Frequently proposed
C) Covered service
D) Experimental
✔✔C - ✔✔Under the Privacy Rule, the minimum necessary standard does NOT apply to
what type of disclosures?:
A) Uses or disclosures to drug companies.
B) Disclosures to or requests by family members.
C) Disclosures to the individual who is the subject of the information.
D) Uses or disclosures to insurance companies.
✔✔B - ✔✔Which is not one of the seven key components of an internal compliance
plan?:
A) Develop open lines of communication.
B) Conduct training but not perform education on practice standards and procedures.
C) Enforce disciplinary standards through well-publicized guidelines.
SURE A+
✔✔A (Rationale: ABNs may not be recognized by non-Medicare payers. Providers
should review their contracts to determine which payers will accept an ABN for services
not covered.) - ✔✔Select the TRUE statement regarding ABNs.
A) ABNs may not be recognized by non-Medicare payers.
B) ABNs must be signed for emergency or urgent care.
C) ABNs are not required to include an estimate cost for the service.
D) ABNs should be routinely signed by Medicare Beneficiaries in case Medicare doesn't
cover a service.
✔✔E (Rationale: Covered entities in relation to HIPAA include Health Care Providers,
Health Plans, and Health Care Clearinghouses. The patient is not considered a covered
entity although it is the patient's data that is protected.) - ✔✔Who would NOT be
considered a covered entity under HIPAA?
A) Doctors
C) HMOs
D) Clearinghouses
E) Patients
✔✔C - ✔✔What type of profession, other than coding, might skilled coders enter?:
A) Physicians, insurance carriers, nurses
B) Front desk personnel, HR dept
C) Consultants, educators, medical auditors
D) None of the above
✔✔D - ✔✔What is the difference between outpatient and inpatient coding?:
A) Outpatient coders use ICD-10-CM and ICD-10-PCS.
B) Outpatient coders only focuse on hospital services and Inpatient coders focuse on
physician services.
C) Inpatient coders have more interaction than Outpatient coders.
D) Inpatient coders use ICD-10-CM and ICD-10-PCS.
✔✔C - ✔✔What is a mid-level provider?
A) Non-licensed PAs
B) Physician withholder
C) Mid-level providers include physician assistants (PA) and nurse practitioners (NP).
D) NPs with Bachelor's Degree
✔✔B - ✔✔What are the different parts of Medicare?
A) Part A, B, D
B) Part A, B, C, D
C) Part E, F, G, H
D) Part A and B
, ✔✔A - ✔✔Evaluation and management (E/M) services are often provided and
documented in a standard format. One such format is SOAP notes. What does SOAP
represent?
A) Subjective, Objective, Assessment, Plan
B) Statement, Observation, Action, Prepare
C) Symptoms, Objective, Auscultation, Percussion
D) Subjective, Observation, Action, Plan
✔✔B - ✔✔What are five tips for coding operative (op) reports?
A) Look for key words, Ignore unfamiliar words, Skip the body, Ignore pathology reports,
Only code procedures from the header
B) Diagnosis code reporting, Start with the procedures listed, Look for key words,
Highlight unfamiliar words, Read the body
C) Highlight familiar words, Look for key words, Read the body, Only code what you
have highlighted, Code procedure only
D) Read the headers only, Look for key words, Highlight familiar words, Ignore
pathology report, Code diagnosis only
✔✔D - ✔✔What is medical necessity?:
A) Services to a Medicare beneficiary that are billed for unreasonable and unnecessary
treatment.
B) The most radical service/procedure that allows for effective treatment of the patient's
complaint or condition.
C) Something insurance plans do not care about.
D) Relates to whether a procedure or service is considered appropriate in a given
circumstance.
✔✔C - ✔✔What is not a common reason Medicare may deny a procedure or service?:
A) Patient's condition
B) Frequently proposed
C) Covered service
D) Experimental
✔✔C - ✔✔Under the Privacy Rule, the minimum necessary standard does NOT apply to
what type of disclosures?:
A) Uses or disclosures to drug companies.
B) Disclosures to or requests by family members.
C) Disclosures to the individual who is the subject of the information.
D) Uses or disclosures to insurance companies.
✔✔B - ✔✔Which is not one of the seven key components of an internal compliance
plan?:
A) Develop open lines of communication.
B) Conduct training but not perform education on practice standards and procedures.
C) Enforce disciplinary standards through well-publicized guidelines.
