AAPC CPC Final Exam a PLUS Questions
and Answers Verified Solutions Latest
Update 2026/2027
Question:
What form is provided to a patient to indicate a servicemay not be covered by Medicare and the
patient may be responsible for the charges?:
A) LCD
B) CMS-1500
C) UB-04
D) ABN.
Answer:
D (Rationale: An Advanced Beneficiary Notice (ABN) is used when a Medicare beneficiary
requests or agrees to receive a procedure or service that Medicare may not cover. This form notifies
the patient of potential out of pocket costs for the patient.)
Question:
Under HIPAA, what would be a policy requirement for "minimum necessary"? "
A) Only individuals whose job requires it may have access to
protected health information.
B) Only the patient has access to his or her own protected health
information.
C) Only the treating provider has access to protected health
information.
D) Anyone within the provider's office can have access to protected
health information..
Answer:
A (Rationale: It is the responsibility of a covered entity to develop and implement policies, best
suited to its particular circumstances to meet HIPAA requirements. As a policy requirement, only
those individuals whose job requires it may have access to protected health information.)
Question:
, Which statement describes a medically necessary service?:
A) Performing a procedure/service based on cost to eliminate
wasteful services.
B) Using the least radical service/procedure that allows for effective
treatment of the patient's complaint or condition.
C) Using the closest facility to perform a service or procedure.
D) Using the appropriate course of treatment to fit within the
patient's lifestyle..
Answer:
B (Rationale: Medical necessity is using the least radical services/procedure that allows for
effective treatment of the patient's complaint or condition.)
Question:
According to the example LCD from Novitas Solutions, which of the following conditions is
considered a systemic condition that may result in the need for routine foot care?:
A) arthritis
B) chronic venous insufficiency
C) hypertension
D) muscle weakness.
Answer:
B (Rationale: According to the LCD, Chronic venous insufficiency is a systemic condition that may
result in the need for routine foot care.)
Question:
When presenting a cost estimate on an ABN for a potentially noncovered service, the cost estimate
should be within what range of the actual cost?
A) $25 or 10 percent
B) $100 or 10 percent
C) $100 or 25 percent
D) An exact amount.
Answer:
C (Rationale: CMS instructions stipulate, "Notifiers must make a good faith effort to insert a
reasonable estimate...the estimate should be within $100 or 25 percent of the actual costs,
whichever is greater.")
and Answers Verified Solutions Latest
Update 2026/2027
Question:
What form is provided to a patient to indicate a servicemay not be covered by Medicare and the
patient may be responsible for the charges?:
A) LCD
B) CMS-1500
C) UB-04
D) ABN.
Answer:
D (Rationale: An Advanced Beneficiary Notice (ABN) is used when a Medicare beneficiary
requests or agrees to receive a procedure or service that Medicare may not cover. This form notifies
the patient of potential out of pocket costs for the patient.)
Question:
Under HIPAA, what would be a policy requirement for "minimum necessary"? "
A) Only individuals whose job requires it may have access to
protected health information.
B) Only the patient has access to his or her own protected health
information.
C) Only the treating provider has access to protected health
information.
D) Anyone within the provider's office can have access to protected
health information..
Answer:
A (Rationale: It is the responsibility of a covered entity to develop and implement policies, best
suited to its particular circumstances to meet HIPAA requirements. As a policy requirement, only
those individuals whose job requires it may have access to protected health information.)
Question:
, Which statement describes a medically necessary service?:
A) Performing a procedure/service based on cost to eliminate
wasteful services.
B) Using the least radical service/procedure that allows for effective
treatment of the patient's complaint or condition.
C) Using the closest facility to perform a service or procedure.
D) Using the appropriate course of treatment to fit within the
patient's lifestyle..
Answer:
B (Rationale: Medical necessity is using the least radical services/procedure that allows for
effective treatment of the patient's complaint or condition.)
Question:
According to the example LCD from Novitas Solutions, which of the following conditions is
considered a systemic condition that may result in the need for routine foot care?:
A) arthritis
B) chronic venous insufficiency
C) hypertension
D) muscle weakness.
Answer:
B (Rationale: According to the LCD, Chronic venous insufficiency is a systemic condition that may
result in the need for routine foot care.)
Question:
When presenting a cost estimate on an ABN for a potentially noncovered service, the cost estimate
should be within what range of the actual cost?
A) $25 or 10 percent
B) $100 or 10 percent
C) $100 or 25 percent
D) An exact amount.
Answer:
C (Rationale: CMS instructions stipulate, "Notifiers must make a good faith effort to insert a
reasonable estimate...the estimate should be within $100 or 25 percent of the actual costs,
whichever is greater.")
