CPC EXAM QUESTIONS WITH THE LATEST AND UPDATED SCORE.

CPC EXAM QUESTIONS WITH THE LATEST AND UPDATED
SCORE.


1) Abstractor -- Answer ✔✔ hospital employee who converts documented
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procedures and diagnoses into medical codes _ _ _ _ _




2) Abuse -- Answer ✔✔ coding practices that lead to improper reimbursement by
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error because they do not meet medical necessity, ex. changing diagnosis to be
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covered by insurance _ _




3) Accreditation -- Answer ✔✔ an examination process the healthcare facility goes
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through to evaluate the facilities policies, procedures, and performance to meet
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higher standards. _




4) Accredited -- Answer ✔✔ Having seal of approval after being evaluated and
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demonstrating quality standards _ _




5) Act/ Law/ Statute -- Answer ✔✔ Legislation passed through Congress and signed by
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President or passed over his veto _ _ _ _ _




6) Actual Charge -- Answer ✔✔ The amount the provider charges for medical services
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or supplies. Not always paid in full.
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7) Additional Benefits -- Answer ✔✔ Health care services not covered by Medicare
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and are offered through the Medicare Advantage Organization for no additional
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premium. The benefits must equal the ACR (Adjusted Community Rating)
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8) Adjudication -- Answer ✔✔ Health Insurance Claims process at the insurance
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company

9) Adjusted Average Per Capita Cost (AAPCC) -- Answer ✔✔ Estimate of how much
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Medicare will spend in a year for an average beneficiary
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, 10) Administrative Code Sets -- Answer ✔✔ Non-medical code sets that characterize a
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general business situation rather than a medical condition.
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11) Administrative Costs -- Answer ✔✔ Medicare, Medicaid, CMS refer to this as their
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expenses to have the program, operating expenses, program management, etc.
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12) Administrative Data -- Answer ✔✔ Health insurance information stored in
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automated information system about enrollment, eligibility, claims, etc.
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13) Administrative Law Judge (ALJ) -- Answer ✔✔ hearing officer who presides over
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appeal conflicts between providers or beneficiaries, and Medicare contractors
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(MAC's)

14) Administrative Simplification -- Answer ✔✔ Part of HIPAA authorizing HHS (Health
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and Human Services) to 1. adopt standards for transactions & code sets; 2. adopt
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standard identifiers for health plans; 3. adopt standards to protect security & privacy
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_ of personally identifiable health information.
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15) Administrative Simplification Act -- Answer ✔✔ Signed 12/17/01 allows HHS
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(Health & Human Services) to exclude providers from Medicare for HIPAA non-
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compliance of electronic claims and prohibit paper claims except in certain
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situations

16) Admission Date -- Answer ✔✔ The date the patient was admitted for inpatient
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care, outpatient, or start of care. For hospice, enter effective date of election of
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hospice benefits. _




17) Admitting Diagnosis -- Answer ✔✔ Diagnosis code indicating patient's diagnosis at
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admission

18) Admitting Physician -- Answer ✔✔ The doctor responsible for admitting a patient
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to the hospital or other inpatient health facility
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