AAPC CPC CERTIFICATION EXAM
2025/2026 BANK CURRENTLY TESTING
COMPLETE ACTUAL QUESTIONS WITH
DETAILED VERIFIED ANSWERS
EXPERT VERIFIED /ALREADY GRADED
A+
Sebacious glands are a part of which anatomic system? -
....ANSWER...Integumentary
The ABN form is entitled - ....ANSWER...Revised ABN
CMS-R-131 and is available with instructions as a free
download on the CMS website.
The ABN is a standardized form that -
....ANSWER...explains to the patient why Medicare may
deny the particular service or procedure.
The OIG is mandated by public law to engage in activities
to test - ....ANSWER...the efficiency and economy of
,government programs to include investigation of suspected
health care fraud or abuse.
The amount on an ABN should be within how much of the
cost to the patient? - ....ANSWER...$100 or 25% of cost
RATIONALE: CMS instructions stipulate, "Notifires msut
make a good faith effort to insert a reasonable
estimate....the estimate should be within $100 or 25% of
the actual costs, whichever is greater.
The myocardium is thickest around which chamber of the
heart? - ....ANSWER...left ventricle
The term "medical necessity refers to -
....ANSWER...whether a procedure or service is considered
appropriate in a given circumstance.
The tunica vaginalis is part of which system? -
....ANSWER...male reproductive
,Under the Privacy rule, the minimum necessary standard
of HIPAA does not apply to - ....ANSWER...* disclosures
to or requests by a health care provider for treatment
purposes
* disclosures to the individual who is the subject of the
information
* uses or disclosures made pursuant to an individual's
authorization
* uses or disclosures required for compliance with the
HIPAA Administrative Simplification Rules
* Disclosures to the US Dept of Health and Human Services
when disclosure of info is required under the Privacy Rule
for enforcement purposes.
* Uses or disclosures that are required by other law
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 is an NCD interpreted at the MAC level considered?
- ....ANSWER...LCD
, Each MAC (Medicare Adminstrative Contractor) is
responsible for interpreting national policies into regional
policies, or Local Coverage Determinations
What is the result of a ureteral blockage? -
....ANSWER...Urine will not be able to flow from the
kidney to the bladder
When does the OIG release a work plan outlining its
priorities for the fiscal year ahead? -
....ANSWER...October
When should an ABN be signed? - ....ANSWER...When a
service is not expecgted to be covered by Medicare.
RATIONALE: This form explains to the patient why a
service MAY be denied by Medicare. The ABN form
should be completed for services potentially con-covered
by Medicare to advise the patient of potential financial
responsibility.
2025/2026 BANK CURRENTLY TESTING
COMPLETE ACTUAL QUESTIONS WITH
DETAILED VERIFIED ANSWERS
EXPERT VERIFIED /ALREADY GRADED
A+
Sebacious glands are a part of which anatomic system? -
....ANSWER...Integumentary
The ABN form is entitled - ....ANSWER...Revised ABN
CMS-R-131 and is available with instructions as a free
download on the CMS website.
The ABN is a standardized form that -
....ANSWER...explains to the patient why Medicare may
deny the particular service or procedure.
The OIG is mandated by public law to engage in activities
to test - ....ANSWER...the efficiency and economy of
,government programs to include investigation of suspected
health care fraud or abuse.
The amount on an ABN should be within how much of the
cost to the patient? - ....ANSWER...$100 or 25% of cost
RATIONALE: CMS instructions stipulate, "Notifires msut
make a good faith effort to insert a reasonable
estimate....the estimate should be within $100 or 25% of
the actual costs, whichever is greater.
The myocardium is thickest around which chamber of the
heart? - ....ANSWER...left ventricle
The term "medical necessity refers to -
....ANSWER...whether a procedure or service is considered
appropriate in a given circumstance.
The tunica vaginalis is part of which system? -
....ANSWER...male reproductive
,Under the Privacy rule, the minimum necessary standard
of HIPAA does not apply to - ....ANSWER...* disclosures
to or requests by a health care provider for treatment
purposes
* disclosures to the individual who is the subject of the
information
* uses or disclosures made pursuant to an individual's
authorization
* uses or disclosures required for compliance with the
HIPAA Administrative Simplification Rules
* Disclosures to the US Dept of Health and Human Services
when disclosure of info is required under the Privacy Rule
for enforcement purposes.
* Uses or disclosures that are required by other law
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 is an NCD interpreted at the MAC level considered?
- ....ANSWER...LCD
, Each MAC (Medicare Adminstrative Contractor) is
responsible for interpreting national policies into regional
policies, or Local Coverage Determinations
What is the result of a ureteral blockage? -
....ANSWER...Urine will not be able to flow from the
kidney to the bladder
When does the OIG release a work plan outlining its
priorities for the fiscal year ahead? -
....ANSWER...October
When should an ABN be signed? - ....ANSWER...When a
service is not expecgted to be covered by Medicare.
RATIONALE: This form explains to the patient why a
service MAY be denied by Medicare. The ABN form
should be completed for services potentially con-covered
by Medicare to advise the patient of potential financial
responsibility.
