AAPC CPC EXAM | ACTUAL QUESTIONS AND VERIFIED ANSWERS NEW UPDATE|PASS GUARANTEE|GRADED A+

AAPC CPC EXAM | ACTUAL QUESTIONS AND
VERIFIED ANSWERS NEW 2026-2027 UPDATE|PASS
GUARANTEE|GRADED A+


Question 1

What document is referenced to when looking for potentialproblem areas identified by
the government indicatingscrutiny of the services within the coming year?:

A) OIG Compliance Plan Guidance

B) OIG Security Summary

C) OIG Work Plan

D) OIG Investigation Plan

CORRECT ANSWER

C (Rationale: Twice a year, the OIG releases a Work Plan outlining its priorities for the
fiscal year ahead. Within the Work Plan, potential problem areas with claims
submissions are listed and will be targeted with special scrutiny.)




Question 2

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

CORRECT 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.)




1
@https://www.stuvia.com/user/thestudyvault

,Question 3

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.

CORRECT 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 4

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.

CORRECT 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 5

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? :


2
@https://www.stuvia.com/user/thestudyvault

, A) arthritis

B) chronic venous insufficiency

C) hypertension

D) muscle weakness

CORRECT 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 6

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

CORRECT 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.")




Question 7

Which act was enacted as part of the American Recovery and Reinvestment Act of 2009
(ARRA) and affected privacy and security? :

A) HIPAA

B) HITECH

C) SSA

D) PPACA


3
@https://www.stuvia.com/user/thestudyvault