AAPC CPC EXAM [2026] | COMPLETE ANSWER GUIDE |
UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS
• What is medical coding? -✓✓ANSWER: The process of translating this written or
dictated medical record into a series of numeric and alphanumeric codes.
• What are the two primary types of insurance? -✓✓ANSWER: Commercial and
government
• What is medicare part A? -✓✓ANSWER: Covers inpatient hospital care, as well
as care provided in skilled nursing facilities, hospice care, and home health care
• What is medicare part B? -✓✓ANSWER: Covered Medically necessary doctors'
services, outpatient care, other medical services (including some preventive
service not covered under Medicare Part A
• What is medicare part C? -✓✓ANSWER: Combines the benefits of Medicare Part
A, Part B, and sometimes Part D.
• What is medicare part D -✓✓ANSWER: Prescription drug coverage program
available to all Medicare beneficiaries. Private companies approved by Medicare
provide the coverage.
• What is Resource based relative value scale (RBRVS) based off of? -✓✓ANSWER:
Physician work, practice expense, and professional liability insurance.
• What does medical necessity mean? -✓✓ANSWER: Whether a procedure or
service is considered appropriate in a given circumstance?
, • What is the "reasonable estimate" according to medicare? -✓✓ANSWER: $100
or 25%
• What is the HIPAA Privacy Rule? -✓✓ANSWER: provides federal protections for
protected health information when held by covered enitites.
• what are covered entities under HIPAA -✓✓ANSWER: health care providers
(doctors), Health plans (Insurance companies, & Healthcare Clearinghouse
• What is HITECH? -✓✓ANSWER: Health Information Technology for Economic
and Clinical Health Act
• When should a ABN be signed? -✓✓ANSWER: When a service is not expected to
be covered by Medicare?
• What OIG document should a provider review for potential problem areas that
will receive special scrutiny in the upcoming year? -✓✓ANSWER: OIG Work Plan
• What are root words? -✓✓ANSWER: The base of the word.
• blephar/o -✓✓ANSWER: eyelid
• bucc/o -✓✓ANSWER: cheek
UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS
• What is medical coding? -✓✓ANSWER: The process of translating this written or
dictated medical record into a series of numeric and alphanumeric codes.
• What are the two primary types of insurance? -✓✓ANSWER: Commercial and
government
• What is medicare part A? -✓✓ANSWER: Covers inpatient hospital care, as well
as care provided in skilled nursing facilities, hospice care, and home health care
• What is medicare part B? -✓✓ANSWER: Covered Medically necessary doctors'
services, outpatient care, other medical services (including some preventive
service not covered under Medicare Part A
• What is medicare part C? -✓✓ANSWER: Combines the benefits of Medicare Part
A, Part B, and sometimes Part D.
• What is medicare part D -✓✓ANSWER: Prescription drug coverage program
available to all Medicare beneficiaries. Private companies approved by Medicare
provide the coverage.
• What is Resource based relative value scale (RBRVS) based off of? -✓✓ANSWER:
Physician work, practice expense, and professional liability insurance.
• What does medical necessity mean? -✓✓ANSWER: Whether a procedure or
service is considered appropriate in a given circumstance?
, • What is the "reasonable estimate" according to medicare? -✓✓ANSWER: $100
or 25%
• What is the HIPAA Privacy Rule? -✓✓ANSWER: provides federal protections for
protected health information when held by covered enitites.
• what are covered entities under HIPAA -✓✓ANSWER: health care providers
(doctors), Health plans (Insurance companies, & Healthcare Clearinghouse
• What is HITECH? -✓✓ANSWER: Health Information Technology for Economic
and Clinical Health Act
• When should a ABN be signed? -✓✓ANSWER: When a service is not expected to
be covered by Medicare?
• What OIG document should a provider review for potential problem areas that
will receive special scrutiny in the upcoming year? -✓✓ANSWER: OIG Work Plan
• What are root words? -✓✓ANSWER: The base of the word.
• blephar/o -✓✓ANSWER: eyelid
• bucc/o -✓✓ANSWER: cheek
