AAPC CERTIFIED PROFESSIONAL CODER
AAPC CERTIFIED PROFESSIONAL CODER
FINAL EXAM 2024/2025 VERIFIED QUESTIONS
AND ANSWERS GRADED A+
Coding is
the process of translating this written or dictated fmedical record into a series of numeric or
alpha-numeric codes
Proper code assignment is determined by
content of the medical record and by the unique rules that governs each code set
what are 3 things that Coder must master
1. anatomy
2. medical terminology
3. must be detail-oriented
Medical coders assign a code to what
1. Each diagnosis
2. service/procedure
3. Supply, using the classification system when applicable
,AAPC CERTIFIED PROFESSIONAL CODER
The classification system determines what
the amount health care providers will be reimbursed if the patient is covered by Medicare,
Medicaid, or other insurance programs using the system
A coder must evaluate the medical record for
1. completeness and accuracy
2. communicate regularly with physicians and othe health care professional to clarify DX or
obtain additonal PT info.
Techicians who speciallize in coding inpatient hospital services are referred as
1. Health information coders
2. medical record coders
3. Coder/abstractors
4. Coding Specialist
What is MS-DRGs and what is it
1. Medicare Severity-Diagnosis Related Groups
2. Determines the amt the hospital will be reimbursed if the PT is covered by Medicare or other
insurance programs
What is EHR
,AAPC CERTIFIED PROFESSIONAL CODER
Electronic health record
Skill coders may become
consulatants, educators or medical auditors
What is the difference between Hospital and Physican Services
1. Outpatient coding (physician services)- learning CPT, HCPCS, LEVEL II, ICD-9 CM codes
Volume 1 and 2
2. Inpatient coding (Hospital services)- Learning CPT, ICD-9 CM codes Volumes 1,2,3 and MS-
DRGS
What is APC and who uses it
Ambulatory Payment Classification- outpatient facility coders (physician services
What is the coder role in a physician's office
Extremely important to proper reimbursement and the livelihood of the physican
What is a physican degree of education
4 years of college, 4 years of medical school plus 3 to 5 years of residency.
, AAPC CERTIFIED PROFESSIONAL CODER
What is a mid-level providers and who
1. Mid-level providers are know as physician extenders
2. Physician assistants (PA) and Nurse Practitioners (NP)
What are the requirement for a PA and what
1. 26 1/2 month to complete
2. Lincense to practice medicine with physician supervision
NP must have
A Master Degree in Nursing
How many payers in the most simplest form?
2
Private insurance plans and government insurance plans
Commerical carriers are considered what
Private payers that offer both group and individual plans.
Private Payers contracts may
Vary but may include hospitalization, basic and major medical coverage.
AAPC CERTIFIED PROFESSIONAL CODER
FINAL EXAM 2024/2025 VERIFIED QUESTIONS
AND ANSWERS GRADED A+
Coding is
the process of translating this written or dictated fmedical record into a series of numeric or
alpha-numeric codes
Proper code assignment is determined by
content of the medical record and by the unique rules that governs each code set
what are 3 things that Coder must master
1. anatomy
2. medical terminology
3. must be detail-oriented
Medical coders assign a code to what
1. Each diagnosis
2. service/procedure
3. Supply, using the classification system when applicable
,AAPC CERTIFIED PROFESSIONAL CODER
The classification system determines what
the amount health care providers will be reimbursed if the patient is covered by Medicare,
Medicaid, or other insurance programs using the system
A coder must evaluate the medical record for
1. completeness and accuracy
2. communicate regularly with physicians and othe health care professional to clarify DX or
obtain additonal PT info.
Techicians who speciallize in coding inpatient hospital services are referred as
1. Health information coders
2. medical record coders
3. Coder/abstractors
4. Coding Specialist
What is MS-DRGs and what is it
1. Medicare Severity-Diagnosis Related Groups
2. Determines the amt the hospital will be reimbursed if the PT is covered by Medicare or other
insurance programs
What is EHR
,AAPC CERTIFIED PROFESSIONAL CODER
Electronic health record
Skill coders may become
consulatants, educators or medical auditors
What is the difference between Hospital and Physican Services
1. Outpatient coding (physician services)- learning CPT, HCPCS, LEVEL II, ICD-9 CM codes
Volume 1 and 2
2. Inpatient coding (Hospital services)- Learning CPT, ICD-9 CM codes Volumes 1,2,3 and MS-
DRGS
What is APC and who uses it
Ambulatory Payment Classification- outpatient facility coders (physician services
What is the coder role in a physician's office
Extremely important to proper reimbursement and the livelihood of the physican
What is a physican degree of education
4 years of college, 4 years of medical school plus 3 to 5 years of residency.
, AAPC CERTIFIED PROFESSIONAL CODER
What is a mid-level providers and who
1. Mid-level providers are know as physician extenders
2. Physician assistants (PA) and Nurse Practitioners (NP)
What are the requirement for a PA and what
1. 26 1/2 month to complete
2. Lincense to practice medicine with physician supervision
NP must have
A Master Degree in Nursing
How many payers in the most simplest form?
2
Private insurance plans and government insurance plans
Commerical carriers are considered what
Private payers that offer both group and individual plans.
Private Payers contracts may
Vary but may include hospitalization, basic and major medical coverage.
