[AAPC - CPC Prep] Final Review
i i i i i
Whatitypeiofiprofession,iotherithanicoding,imightiskilledicodersienter?i-i
i ✅Consultants,ieducators,imedicaliauditors.
Whatiisitheidifferenceibetweenioutpatientiandiinpatienticoding?i-i
i ✅InpatienticodersiuseiICD-10-CMiandiICD-10-PCS.
Whatiisiaimid-leveliprovider?i-i
i ✅Mid-leveliprovidersiincludeiphysicianiassistantsi(PA)iandinurseipractitionersi(NP).
WhatiareitheidifferentipartsiofiMedicare?i-i
i ✅PartiA,iB,iC,iD.
Evaluationiandimanagementi(E/M)iservicesiareiofteniprovidediandidocumentediiniaistandardiformat.iO
neisuchiformatiisiSOAPinotes.iWhatidoesiSOAPirepresent?i-i
i ✅Subjective,iObjective,iAssessment,iPlan.
Whatiareifiveitipsiforicodingioperativei(op)ireports?i-i
✅Diagnosisicodeireporting,iStartiwithitheiproceduresilisted,iLookiforikeyiwords,iHighlightiunfamiliariw
i
ords,iReaditheibody.
Whatiisimedicalinecessity?i-i
i ✅Relatesitoiwhetheriaiprocedureioriserviceiisiconsiderediappropriateiiniaigivenicircumstance.
WhatiisinotiaicommonireasoniMedicareimayidenyiaiprocedureioriservice?i-i
i ✅Coverediservice.
UnderitheiPrivacyiRule,itheiminimuminecessaryistandardidoesiNOTiapplyitoiwhatitypeiofidisclosures?i-i
i ✅Disclosuresitoitheiindividualiwhoiisitheisubjectiofitheiinformation.
1i|iP a g e
,Whichiisinotioneiofitheisevenikeyicomponentsiofianiinternalicomplianceiplan?i-i
i ✅Conductitrainingibutinotiperformieducationionipracticeistandardsiandiprocedures.
WhatidocumentiassistsiprovideriofficesiwithitheidevelopmentiofiComplianceiManuals?i-i
i ✅OIGiComplianceiProgramiGuidance.
Whichistatementidescribesiaimedicallyinecessaryiservice?i-i
✅Usingitheileastiradicaliservice/procedureithatiallowsiforieffectiveitreatmentiofitheipatient'sicomplai
i
ntioricondition.
Whatidocumentiisireferenceditoiwhenilookingiforipotentialiproblemiareasiidentifiedibyitheigovernmenti
indicatingiscrutinyiofitheiservices?i-i
i ✅OIGiWorkiPlan.
UnderiHIPAA,iwhatiwouldibeiaipolicyirequirementifori"minimuminecessary"?i-i
i ✅Onlyiindividualsiwhoseijobirequiresiitimayihaveiaccessitoiprotectedihealthiinformation.
WhichiactiwasienactediasipartiofitheiAmericaniRecoveryiandiReinvestmentiActiofi2009i(ARRA)iandiaffect
ediprivacyiandisecurity?i-i
i ✅HITECH.
WhoiwouldiNOTibeiconsiderediaicoveredientityiunderiHIPAA?i-i
i ✅Patients.
WhenipresentingiaicostiestimateionianiABNiforiaipotentiallyinoncoverediservice,itheicostiestimateishoul
dibeiwithiniwhatirangeiofitheiactualicost?i-i
i ✅$100iori25ipercent.
AccordingitoitheiexampleiLCDifromiNovitasiSolutions,iwhichiofitheifollowingiconditionsiisiconsiderediais
ystemiciconditionithatimayiresultiinitheineediforiroutineifooticare?i-i
i ✅Chronicivenousiinsufficiency.
2i|iP a g e
,SelectitheiTRUEistatementiregardingiABNs.i-i
i ✅ABNsimayinotibeirecognizedibyinon-Medicareipayers.
WhatiformiisiprovideditoiaipatientitoiindicateiaiserviceimayinotibeicoveredibyiMedicareianditheipatienti
mayibeiresponsibleiforitheicharges?i-i
i ✅ABN.
WhichioptionibelowiisiNOTiaicoveredientityiunderiHIPAA?i-i
i ✅Workers'iCompensation.
IfianiNCDidoesinotiexistiforiaiparticulariservice/procedureiperformedioniaiMedicareipatient,iwhoideterm
inesicoverage?i-i
i ✅MedicareiAdministrativeiContractori(MAC).
Whatiisitheivalueiofiairemittanceiadvice?i-i
i ✅Itistatesiwhatiwillibeipaidiandiwhyianyichangesitoichargesiwereimade.
Voluntaryicomplianceiprogramsialsoiprovideibenefitsibyinotionlyihelpingitoipreventierroneousiori____,i
butialsoibyishowingithatitheiprovideripracticeiisimakingiadditionaligoodifaithieffortsitoisubmiticlaimsiapp
ropriately.i-i
i ✅Fraudulenticlaims
WhatitypeiofiinsuranceiisiMedicareiPartiD?i-i
i ✅PrescriptionidrugicoverageiavailableitoialliMedicareibeneficiaries.
LCDsionlyihaveijurisdictioniinitheiri____.i-i
i ✅Region
HITECHiprovidesiai____idayiwindowiduringiwhichianyiviolationinotidueitoiwillfulineglectimayibeicorrecte
diwithoutipenalty.i-i
i ✅30
3i|iP a g e
, EHRistandsifor:i-i
i ✅Electronicihealthirecord.
WhichiofitheifollowingiisiaiBENEFITiofielectronicitransactions?i-i
i ✅Timelyisubmissionioficlaims
IniwhatiyeariwasitheiAAPCifounded?i-i
i ✅1988.
Manyicodingiprofessionalsigoionitoifindiworkias:i-i
i ✅Consultants.
HIPAAistandsifori-i
i ✅HealthiInsuranceiPortabilityiandiAccountabilityiAct.
Professionalsiwhoispecializeiinicodingiareicalled:i-i
i ✅Codingispecialists.
WhatiisiPHI?i-i
i ✅Protectedihealthiinformation.
WhatidoesitheiabbreviationiMACistandifor?i-i
i ✅MedicareiAdministrativeiContractor.
Healthcareiprovidersiareiresponsibleiforidevelopingi____iandipoliciesiandiproceduresiregardingiprivacyi
initheiripractices.i-i
i ✅NoticesiofiPrivacyiPractices
IniwhatiyeariwasiHITECHienactediasipartiofitheiAmericaniRecoveryiandiReinvestmentiAct?i-i
i ✅2009.
4i|iP a g e
i i i i i
Whatitypeiofiprofession,iotherithanicoding,imightiskilledicodersienter?i-i
i ✅Consultants,ieducators,imedicaliauditors.
Whatiisitheidifferenceibetweenioutpatientiandiinpatienticoding?i-i
i ✅InpatienticodersiuseiICD-10-CMiandiICD-10-PCS.
Whatiisiaimid-leveliprovider?i-i
i ✅Mid-leveliprovidersiincludeiphysicianiassistantsi(PA)iandinurseipractitionersi(NP).
WhatiareitheidifferentipartsiofiMedicare?i-i
i ✅PartiA,iB,iC,iD.
Evaluationiandimanagementi(E/M)iservicesiareiofteniprovidediandidocumentediiniaistandardiformat.iO
neisuchiformatiisiSOAPinotes.iWhatidoesiSOAPirepresent?i-i
i ✅Subjective,iObjective,iAssessment,iPlan.
Whatiareifiveitipsiforicodingioperativei(op)ireports?i-i
✅Diagnosisicodeireporting,iStartiwithitheiproceduresilisted,iLookiforikeyiwords,iHighlightiunfamiliariw
i
ords,iReaditheibody.
Whatiisimedicalinecessity?i-i
i ✅Relatesitoiwhetheriaiprocedureioriserviceiisiconsiderediappropriateiiniaigivenicircumstance.
WhatiisinotiaicommonireasoniMedicareimayidenyiaiprocedureioriservice?i-i
i ✅Coverediservice.
UnderitheiPrivacyiRule,itheiminimuminecessaryistandardidoesiNOTiapplyitoiwhatitypeiofidisclosures?i-i
i ✅Disclosuresitoitheiindividualiwhoiisitheisubjectiofitheiinformation.
1i|iP a g e
,Whichiisinotioneiofitheisevenikeyicomponentsiofianiinternalicomplianceiplan?i-i
i ✅Conductitrainingibutinotiperformieducationionipracticeistandardsiandiprocedures.
WhatidocumentiassistsiprovideriofficesiwithitheidevelopmentiofiComplianceiManuals?i-i
i ✅OIGiComplianceiProgramiGuidance.
Whichistatementidescribesiaimedicallyinecessaryiservice?i-i
✅Usingitheileastiradicaliservice/procedureithatiallowsiforieffectiveitreatmentiofitheipatient'sicomplai
i
ntioricondition.
Whatidocumentiisireferenceditoiwhenilookingiforipotentialiproblemiareasiidentifiedibyitheigovernmenti
indicatingiscrutinyiofitheiservices?i-i
i ✅OIGiWorkiPlan.
UnderiHIPAA,iwhatiwouldibeiaipolicyirequirementifori"minimuminecessary"?i-i
i ✅Onlyiindividualsiwhoseijobirequiresiitimayihaveiaccessitoiprotectedihealthiinformation.
WhichiactiwasienactediasipartiofitheiAmericaniRecoveryiandiReinvestmentiActiofi2009i(ARRA)iandiaffect
ediprivacyiandisecurity?i-i
i ✅HITECH.
WhoiwouldiNOTibeiconsiderediaicoveredientityiunderiHIPAA?i-i
i ✅Patients.
WhenipresentingiaicostiestimateionianiABNiforiaipotentiallyinoncoverediservice,itheicostiestimateishoul
dibeiwithiniwhatirangeiofitheiactualicost?i-i
i ✅$100iori25ipercent.
AccordingitoitheiexampleiLCDifromiNovitasiSolutions,iwhichiofitheifollowingiconditionsiisiconsiderediais
ystemiciconditionithatimayiresultiinitheineediforiroutineifooticare?i-i
i ✅Chronicivenousiinsufficiency.
2i|iP a g e
,SelectitheiTRUEistatementiregardingiABNs.i-i
i ✅ABNsimayinotibeirecognizedibyinon-Medicareipayers.
WhatiformiisiprovideditoiaipatientitoiindicateiaiserviceimayinotibeicoveredibyiMedicareianditheipatienti
mayibeiresponsibleiforitheicharges?i-i
i ✅ABN.
WhichioptionibelowiisiNOTiaicoveredientityiunderiHIPAA?i-i
i ✅Workers'iCompensation.
IfianiNCDidoesinotiexistiforiaiparticulariservice/procedureiperformedioniaiMedicareipatient,iwhoideterm
inesicoverage?i-i
i ✅MedicareiAdministrativeiContractori(MAC).
Whatiisitheivalueiofiairemittanceiadvice?i-i
i ✅Itistatesiwhatiwillibeipaidiandiwhyianyichangesitoichargesiwereimade.
Voluntaryicomplianceiprogramsialsoiprovideibenefitsibyinotionlyihelpingitoipreventierroneousiori____,i
butialsoibyishowingithatitheiprovideripracticeiisimakingiadditionaligoodifaithieffortsitoisubmiticlaimsiapp
ropriately.i-i
i ✅Fraudulenticlaims
WhatitypeiofiinsuranceiisiMedicareiPartiD?i-i
i ✅PrescriptionidrugicoverageiavailableitoialliMedicareibeneficiaries.
LCDsionlyihaveijurisdictioniinitheiri____.i-i
i ✅Region
HITECHiprovidesiai____idayiwindowiduringiwhichianyiviolationinotidueitoiwillfulineglectimayibeicorrecte
diwithoutipenalty.i-i
i ✅30
3i|iP a g e
, EHRistandsifor:i-i
i ✅Electronicihealthirecord.
WhichiofitheifollowingiisiaiBENEFITiofielectronicitransactions?i-i
i ✅Timelyisubmissionioficlaims
IniwhatiyeariwasitheiAAPCifounded?i-i
i ✅1988.
Manyicodingiprofessionalsigoionitoifindiworkias:i-i
i ✅Consultants.
HIPAAistandsifori-i
i ✅HealthiInsuranceiPortabilityiandiAccountabilityiAct.
Professionalsiwhoispecializeiinicodingiareicalled:i-i
i ✅Codingispecialists.
WhatiisiPHI?i-i
i ✅Protectedihealthiinformation.
WhatidoesitheiabbreviationiMACistandifor?i-i
i ✅MedicareiAdministrativeiContractor.
Healthcareiprovidersiareiresponsibleiforidevelopingi____iandipoliciesiandiproceduresiregardingiprivacyi
initheiripractices.i-i
i ✅NoticesiofiPrivacyiPractices
IniwhatiyeariwasiHITECHienactediasipartiofitheiAmericaniRecoveryiandiReinvestmentiAct?i-i
i ✅2009.
4i|iP a g e