Aapc Official Cpc Certification Study Guide Notes With Complete Solutions

Aapc Official Cpc Certification Study b b b b




Guide Notes With Complete Solutions
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"hold bharmless bclause" b- b bcorrect banswer- b* bfound bin bsome bnon-Medicare bhealth
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bplan bcontracts
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* bprohibits bbilling bto bpatient bfor banything bbeyond bdeductibles band bco-pays.
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A bcompliance bplan bmay boffer bseveral bbenefits, bincluding: b- b bcorrect banswer- b*
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bmore baccurate bpayment bof bclaims
b b b b b




* bfewer bbilling bmistakes
b b b




* bimproved bdocumentation band bmore baccurate bcoding
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* bless bchance bof bviolating bself-referral band banti-kickback bstatus
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A bhealthcare bclearing bhouse bis ba b- b bcorrect banswer- bentity bthat bprocesses
b b b b b b b b b b b b




bnonstandard bhealth binformation bthey breceive bfrom banother bentity binto ba
b b b b b b b b b b




bstandard bformat
b b




A bkey bprovision bin bHIPAA bis bthe bMinimum bNecessary brequirement. bthis bmeans b-
b b b b b b b b b b b b




b bcorrect banswer- bonly bthe bminimum bnecessary bprotected bhealth binformation
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bshould bbe bshared bto bsatisfy ba bparticular bpurpose.
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A bmedically bnecessary bservice bis bthe b- b bcorrect banswer- bleast bradical
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bservice/procedure bthat ballows bfor beffective btreatment bof bthe bpatients' bcomplaint
b b b b b b b b b b




bor bcondition
b b




A bpatient bsustaining ban binjury bto bher bgreat bsaphenous bvein bwould bhave
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bsustained binjury bto bwhich bof banatomical bsite? b- b bcorrect banswer- bLeg
b b b b b b b b b b b b




APC b- b bcorrect banswer- bAmbulatory bPayment bClassification
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ARRA b- b bcorrect banswer- bAmerican bRecovery band bReinvestment bAct b(of b2009)
b b b b b b b b b b b




ASC b- b bcorrect banswer- bAmbulatory bSurgical bCenters
b b b b b b b




Abuse bconsists bof b- b bcorrect banswer- bpayment bfor bitems bor bservices bthat bare
b b b b b b b b b b b b b




bbilled bby bproviders bin berror bthat bshould bnot bbe bpaid bfor bby bMedicare.
b b b b b b b b b b b b b

, An bABN bprotects bthe bprovider's bfinancial binterest bby b- b bcorrect banswer- bcreating
b b b b b b b b b b b b




ba bpaper btrail bthat bCMS brequires bbefore ba bprovider bcan bbill bthe bpatient bfor
b b b b b b b b b b b b b b




bpayment bif bMedicare bdenies bcoverage bfor bthe bstated bservice bor bprocedure.
b b b b b b b b b b b




An bentity bthat bprocesses bnonstandard bhealth binformation bthey breceive bfrom
b b b b b b b b b




banother bentity binto ba bstandard bformat bis bconsidered bwhat? b- b bcorrect banswer-
b b b b b b b b b b b b b




bClearinghouse
b




As ba bpart bof bHealth bCare bReform, bthe bAffordable bCare bAct bof b2010 bamended
b b b b b b b b b b b b b




bthe bdefinition bof bfraud bto bremove bthe b__________ brequirement b- b bcorrect
b b b b b b b b b b b b




banswer- bintent
b b




By bstatute, ball bwork bRVUs, bmust bbe bexamined bno bless boften bthan b- b bcorrect
b b b b b b b b b b b b b b




banswer- bevery b5 byears
b b b b




CF b- b bcorrect banswer- bCoversion bFactor b- bfixed bdollar bamount bused bto btranslate
b b b b b b b b b b b b b




bthe bRVUs binto bfees
b b b b




CMS b- b bcorrect banswer- bCenters bfor bMedicare band bMedicaid
b b b b b b b b b




CMS bdeveloped bpolices bregarding bmedical bnecessity bare bbased bon bregulations
b b b b b b b b b




bfound bin btitle bXVIII, b$1862(a) bof bthe b- b bcorrect banswer- bSocial bSecurity bAct
b b b b b b b b b b b b b b




CMS bwill baccept bthe b____________ bfor beither ba b"potentially bnon=covered"
b b b b b b b b b




bservice bor bfor ba bstatutorily bexcluded bservice b- b bcorrect banswer- bCMS-R-131
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CMS-R-131 b- b bcorrect banswer- bABN bform b b b b b b b b




or

Advance bBeneficiary bNotice bwhich bexplains bto bthe bpatient bwhy bMedicare bmay
b b b b b b b b b b




bdeny bthe bparticular bservice bor bprocedure.
b b b b b b




CPT b- b bcorrect banswer- bCurrent bProcedural bTerminology
b b b b b b b




CY b2013 bConversion bFactor b- b bcorrect banswer- b$25.0008
b b b b b b b b




Commercial b(non-Medicare) bmay bdevelop btheir bown bmedical bpolicies bwhich bdo b b b b b b b b b




bnot bfollow bMedicare bguidelines band bare bspecified bin b- b bcorrect banswer- bprivate
b b b b b b b b b b b b b




bcontracts bbetween bthe bpayer band bpractice bor bprovider
b b b b b b b b




DRG b- b bcorrect banswer- bDiagnosis bRelated bGroup
b b b b b b b




Does bMedicare bPart bB bgenerally brequire ba byearly bdeductable band bcopayment? b-
b b b b b b b b b b b




b bcorrect banswer- byes
b b b b




E/M bOR bE&M b- b bcorrect banswer- bEvaluation band bManagement
b b b b b b b b b




EHR b- b bcorrect banswer- bElectronic bHealth bRecord
b b b b b b b