AAPC FINAL EXAM QUESTIONS WITH
CORRECT ANSWERS 2026
What form is provided to a patient to indicate a service may not be covered by medicare and the patien
t may be responsible for the charges? - correct answer-ABN
Under HIPAA what would be a policy requirement for "minimum necessary"? - correct answer-
Only individuals whos job requires it may have access to protected health information
What document is referenced to when looking for potential problem areas indentified by the governme
nt indicating scrutiny of the service? - correct answer-OIG work plan
Select the true statement regarding ABNs - correct answer-
A. ABNs may not be recognized by non medicare payers
Which act was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA) and affe
cted privacy and security? - correct answer-HITECH
When presenting a cost estimate of an ABN for potentially non covered service, the cost estimate shoul
d be written what range of the actual cost? - correct answer-$100 or 25%
According to the example LCD from novitas solutions, which of the following conditions is considered a s
ystematic condition that may result in the need for routine foot care? - correct answer-
Chronic Venous Insufficiency
Who would NOT be considered a covered enity under HIPAA - correct answer-Patients
What document assists provider offices with the development of compliance manuals? -
correct answer-OIG complaince program guidance
Which statement describes a medically necessary service? - correct answer-
Using the least radical service/ procedures that allow for effective treatment of the patient's complaints
or condition
, What type of profession, other than coding, might skilled coders enter? - correct answer-
Consultants, educators, medical auditors
What is the difference between outpatient and inpatient coding? - correct answer-
Inpatient coders use ICD-10-CM and ICD-10-PCS
Whatxisxaxmidxlevelxprovider?x-xcorrectxanswer-mid-
levelxprovidersxincludexphysicianxassistantsx(PA)xandxnursexpractitionersx(NP)
Whatxonexisxthexdifferencexpartsxofxmedicare?x-xcorrectxanswer-
PartxA,B,C,D
EvaluationxandxManagementx(E/M)xservicesxarexoſtenxprovidedxandxdocumentedxinxaxstandardxformat.x
O
nexsuchxasxSOAPxnotes.xWhatxdoesxSOAPxrepresent?x-xcorrectxanswer-
Subjective,xObjective,xAssessment,xPlan
Whatxarexfivextipsxforxcodingxoperativex(OP)xreportsx-xcorrectxanswer-
diagnosisxcodexreporting,xStartxwithxthexproceduresxlisted,xLookxforxkeyxwords,xhighlightxunfamiliarxwor
d
s,xreadxthexbody
Whatxisxmedicalxnecessity?x-xcorrectxanswer-
Relatesxtoxwhetherxaxprocedurexorxservicexisxconsideredxappropriatexinxaxgivenxcircumstanc
e.
WhatxisxNOTxaxcommonxreasonxmedicarexmayxdenyxaxprocedurexorxservice?x-
xcorrectxanswer-
coveredxservice
UnderxthexPrivacyxrulemxthexminimumxnecessaryxstandardxdoesxnotxapplyxtoxwhatxtypexofxdisclosures
?x-
correctxanswer-Disclosuresxtoxthexindividualxwhoxisxthexsubjectxofxthexinformation
WhichxisxNOTxonexofxthexsevenxkeyxcomponentsxofxinternalxcomplaincexplan?x-
xcorrectxanswer-
Conductxtrainingxbutxnotxperformxeducationxonxpracticexstandardsxandxprocedures
ABNxstandsxfor?x-xcorrectxanswer-AdvancexBeneficiaryxNotice
CORRECT ANSWERS 2026
What form is provided to a patient to indicate a service may not be covered by medicare and the patien
t may be responsible for the charges? - correct answer-ABN
Under HIPAA what would be a policy requirement for "minimum necessary"? - correct answer-
Only individuals whos job requires it may have access to protected health information
What document is referenced to when looking for potential problem areas indentified by the governme
nt indicating scrutiny of the service? - correct answer-OIG work plan
Select the true statement regarding ABNs - correct answer-
A. ABNs may not be recognized by non medicare payers
Which act was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA) and affe
cted privacy and security? - correct answer-HITECH
When presenting a cost estimate of an ABN for potentially non covered service, the cost estimate shoul
d be written what range of the actual cost? - correct answer-$100 or 25%
According to the example LCD from novitas solutions, which of the following conditions is considered a s
ystematic condition that may result in the need for routine foot care? - correct answer-
Chronic Venous Insufficiency
Who would NOT be considered a covered enity under HIPAA - correct answer-Patients
What document assists provider offices with the development of compliance manuals? -
correct answer-OIG complaince program guidance
Which statement describes a medically necessary service? - correct answer-
Using the least radical service/ procedures that allow for effective treatment of the patient's complaints
or condition
, What type of profession, other than coding, might skilled coders enter? - correct answer-
Consultants, educators, medical auditors
What is the difference between outpatient and inpatient coding? - correct answer-
Inpatient coders use ICD-10-CM and ICD-10-PCS
Whatxisxaxmidxlevelxprovider?x-xcorrectxanswer-mid-
levelxprovidersxincludexphysicianxassistantsx(PA)xandxnursexpractitionersx(NP)
Whatxonexisxthexdifferencexpartsxofxmedicare?x-xcorrectxanswer-
PartxA,B,C,D
EvaluationxandxManagementx(E/M)xservicesxarexoſtenxprovidedxandxdocumentedxinxaxstandardxformat.x
O
nexsuchxasxSOAPxnotes.xWhatxdoesxSOAPxrepresent?x-xcorrectxanswer-
Subjective,xObjective,xAssessment,xPlan
Whatxarexfivextipsxforxcodingxoperativex(OP)xreportsx-xcorrectxanswer-
diagnosisxcodexreporting,xStartxwithxthexproceduresxlisted,xLookxforxkeyxwords,xhighlightxunfamiliarxwor
d
s,xreadxthexbody
Whatxisxmedicalxnecessity?x-xcorrectxanswer-
Relatesxtoxwhetherxaxprocedurexorxservicexisxconsideredxappropriatexinxaxgivenxcircumstanc
e.
WhatxisxNOTxaxcommonxreasonxmedicarexmayxdenyxaxprocedurexorxservice?x-
xcorrectxanswer-
coveredxservice
UnderxthexPrivacyxrulemxthexminimumxnecessaryxstandardxdoesxnotxapplyxtoxwhatxtypexofxdisclosures
?x-
correctxanswer-Disclosuresxtoxthexindividualxwhoxisxthexsubjectxofxthexinformation
WhichxisxNOTxonexofxthexsevenxkeyxcomponentsxofxinternalxcomplaincexplan?x-
xcorrectxanswer-
Conductxtrainingxbutxnotxperformxeducationxonxpracticexstandardsxandxprocedures
ABNxstandsxfor?x-xcorrectxanswer-AdvancexBeneficiaryxNotice
