CPC 2021 EXAM STUDY GUIDE WITH
COMPLETE SOLUTIONS
Documentation f(content) f- fcorrect fanswers f-Proper fcode fassignment fis fdetermined
fboth fby f_____________ fin fthe fmedical frecord fand fby fthe funique frules fthat fgovern
feach fcode fset fin fthat finstance
An fauditor f- fcorrect fanswers f-The frole fa fcoder fmay ftake fon fto fverify fthat fthe
fdocumentation fsupports fthe fcodes fthe fphysician fhas fselected
Query fthe fphysician f- fcorrect fanswers f-If fthe fmedical frecord fis finaccurate for
fincomplete, fit fwill fnot ftranslate fproperly fto fthe flanguage fof fcodes. fWhat fcan fa
fcoder fdo fin forder ffor fthe fmedical frecord fto fbe fcomplete fand faccurate fso fthey fcan
fbill fproperly?
Quarterly f(usually) f- fcorrect fanswers f-How foften fare fcodes fand finsurance fpayment
fpolicies fupdated?
, NPP f- fcorrect fanswers f-Non-Physician fProvider f(also fknown fas fmid-level fproviders
for fphysician fextenders)
PA f- fcorrect fanswers f-Physician fassistant
NP f- fcorrect fanswers f-Nurse fpractitioner
Commercial fand fGovernment f- fcorrect fanswers f-The ftwo ftypes fof fprimary
finsurances
Commercial fCarriers f- fcorrect fanswers f-Private fpayers fthat fmay foffer fboth fgroup
fand findividual fplans
Medicare f- fcorrect fanswers f-The fmost fsignificant fgovernment finsurer; fa ffederal
fhealth finsurance fprogram
People fover f65, fblind for fdisabled findividuals, fand fpeople fwith fpermanent fkidney
ffailure for fend-stage frenal fdisease f- fcorrect fanswers f-Medicare fprovides fcoverage
ffor fwhat fkind fof fpeople?
ESRD f- fcorrect fanswers f-end-stage frenal fdisease
Medicare fPart fA f- fcorrect fanswers f-Helps fcover finpatient fhospital fcare, fas fwell fas
fcare fprovided fin fskilled fnursing ffacilities, fhospice fcare, fand fhome fhealthcare,
Medicare fPart fB f- fcorrect fanswers f-Covers fmedically fnecessary fphysicians' fservices,
foutpatient fcare, fand fother fmedical fservices f(including fsome fpreventive fservices) fnot
fcovered funder fMedicare fPart fA. fIt fcan fbe fan foptional fbenefit.
Medicare fPart fC f- fcorrect fanswers f-Also fcalled fMedicare fAdvantage, fcombines fthe
fbenefits fof fMedicare fPart fA, fPart fB, fand-sometimes- fPart fD. fThe fplans fare
fmanaged fby fprivate finsurers fapproved fby fMedicare.
Medicare fPart fD f- fcorrect fanswers f-A fprescription fdrug fprogram favailable fto fall
fMedicare fbeneficiaries.
Medicaid f- fcorrect fanswers f-A fhealth finsurance fassistance fprogram ffor fsome flow-
income fpeople f(especially fchildren fand fpregnant fwomen) fsponsored fby ffederal fand
fstate fgovernments.
RBRVS f- fcorrect fanswers f-Resource-Based fRelative fValue fScale
Resource-Based fRelative fValue fScale f(RBRVS) f- fcorrect fanswers f-Medicare
fpayments ffor fphysician fservices fare fstandardized fusing f_____ fand fare fdivided finto
fthree fcomponents.
COMPLETE SOLUTIONS
Documentation f(content) f- fcorrect fanswers f-Proper fcode fassignment fis fdetermined
fboth fby f_____________ fin fthe fmedical frecord fand fby fthe funique frules fthat fgovern
feach fcode fset fin fthat finstance
An fauditor f- fcorrect fanswers f-The frole fa fcoder fmay ftake fon fto fverify fthat fthe
fdocumentation fsupports fthe fcodes fthe fphysician fhas fselected
Query fthe fphysician f- fcorrect fanswers f-If fthe fmedical frecord fis finaccurate for
fincomplete, fit fwill fnot ftranslate fproperly fto fthe flanguage fof fcodes. fWhat fcan fa
fcoder fdo fin forder ffor fthe fmedical frecord fto fbe fcomplete fand faccurate fso fthey fcan
fbill fproperly?
Quarterly f(usually) f- fcorrect fanswers f-How foften fare fcodes fand finsurance fpayment
fpolicies fupdated?
, NPP f- fcorrect fanswers f-Non-Physician fProvider f(also fknown fas fmid-level fproviders
for fphysician fextenders)
PA f- fcorrect fanswers f-Physician fassistant
NP f- fcorrect fanswers f-Nurse fpractitioner
Commercial fand fGovernment f- fcorrect fanswers f-The ftwo ftypes fof fprimary
finsurances
Commercial fCarriers f- fcorrect fanswers f-Private fpayers fthat fmay foffer fboth fgroup
fand findividual fplans
Medicare f- fcorrect fanswers f-The fmost fsignificant fgovernment finsurer; fa ffederal
fhealth finsurance fprogram
People fover f65, fblind for fdisabled findividuals, fand fpeople fwith fpermanent fkidney
ffailure for fend-stage frenal fdisease f- fcorrect fanswers f-Medicare fprovides fcoverage
ffor fwhat fkind fof fpeople?
ESRD f- fcorrect fanswers f-end-stage frenal fdisease
Medicare fPart fA f- fcorrect fanswers f-Helps fcover finpatient fhospital fcare, fas fwell fas
fcare fprovided fin fskilled fnursing ffacilities, fhospice fcare, fand fhome fhealthcare,
Medicare fPart fB f- fcorrect fanswers f-Covers fmedically fnecessary fphysicians' fservices,
foutpatient fcare, fand fother fmedical fservices f(including fsome fpreventive fservices) fnot
fcovered funder fMedicare fPart fA. fIt fcan fbe fan foptional fbenefit.
Medicare fPart fC f- fcorrect fanswers f-Also fcalled fMedicare fAdvantage, fcombines fthe
fbenefits fof fMedicare fPart fA, fPart fB, fand-sometimes- fPart fD. fThe fplans fare
fmanaged fby fprivate finsurers fapproved fby fMedicare.
Medicare fPart fD f- fcorrect fanswers f-A fprescription fdrug fprogram favailable fto fall
fMedicare fbeneficiaries.
Medicaid f- fcorrect fanswers f-A fhealth finsurance fassistance fprogram ffor fsome flow-
income fpeople f(especially fchildren fand fpregnant fwomen) fsponsored fby ffederal fand
fstate fgovernments.
RBRVS f- fcorrect fanswers f-Resource-Based fRelative fValue fScale
Resource-Based fRelative fValue fScale f(RBRVS) f- fcorrect fanswers f-Medicare
fpayments ffor fphysician fservices fare fstandardized fusing f_____ fand fare fdivided finto
fthree fcomponents.
