AAPC CPC EXAM SCRIPT Questions with Correct Answers (Grade
A+)
Question 1: A compliance plan may offer several benefits, including:.
Answer: * more accurate payment of claims * fewer billing mistakes * improved documentation and more
accurate coding * less chance of violating self-referral and anti-kickback status
Question 2: A healthcare clearing house is a.
Answer: entity that processes nonstandard health information they receive from another entity into a
standard format
Question 3: A key provision in HIPAA is the Minimum Necessary requirement. this means.
Answer: only the minimum necessary protected health information should be shared to satisfy a particular
purpose.
Question 4: A medically necessary service is the.
Answer: least radical service/procedure that allows for effective treatment of the patients' complaint or
condition
Question 5: A patient sustaining an injury to her great saphenous vein would have sustained injury to
which of anatomical site?
Answer: Leg
Question 6: APC.
Answer: Ambulatory Payment Classification
Question 7: ARRA.
Answer: American Recovery and Reinvestment Act (of 2009)
Question 8: ASC.
Answer: Ambulatory Surgical Centers
Question 9: Abuse consists of.
Answer: payment for items or services that are billed by providers in error that should not be paid for by
Medicare.
Page 1
,Question 10: An ABN protects the provider's financial interest by.
Answer: creating a paper trail that CMS requires before a provider can bill the patient for payment if
Medicare denies coverage for the stated service or procedure.
Question 11: An entity that processes nonstandard health information they receive from another entity
into a standard format is considered what?
Answer: Clearinghouse
Question 12: As a part of Health Care Reform, the Affordable Care Act of 2010 amended the definition
of fraud to remove the __________ requirement.
Answer: intent
Question 13: By statute, all work RVUs, must be examined no less often than.
Answer: every 5 years
Question 14: CF.
Answer: Coversion Factor - fixed dollar amount used to translate the RVUs into fees
Question 15: CMS.
Answer: Centers for Medicare and Medicaid
Question 16: CMS developed polices regarding medical necessity are based on regulations found in title
XVIII, $1862(a) of the.
Answer: Social Security Act
Question 17: CMS will accept the ____________ for either a "potentially non=covered" service or for a
statutorily excluded service.
Answer: CMS-R-131
Question 18: CMS-R-131.
Answer: ABN form or Advance Beneficiary Notice which explains to the patient why Medicare may deny
the particular service or procedure.
Question 19: CPT.
Answer: Current Procedural Terminology
Page 2
, Question 20: CY 2013 Conversion Factor.
Answer: $25.0008
Question 21: Commercial (non-Medicare) may develop their own medical policies which do not follow
Medicare guidelines and are specified in.
Answer: private contracts between the payer and practice or provider
Question 22: DRG.
Answer: Diagnosis Related Group
Question 23: Does Medicare Part B generally require a yearly deductable and copayment?
Answer: yes
Question 24: E/M OR E&M.
Answer: Evaluation and Management
Question 25: EHR.
Answer: Electronic Health Record
Question 26: Formula for Calculating Facility Payment amounts.
Answer: [(Work RVU * Work GPCI) + (Transitioned Facility PE RVU * PE GPCI) + (MP RVU * MP
GPCI)] * CF
Question 27: Formula for Non-Facility Pricing Amount.
Answer: [(Work RVU * Work GPCI) + (Transitioned Non-Facility PE RVU * PE GPCI) + (MP RVU * MP
GPCI)] * (CF)
Question 28: GPCI.
Answer: Geographic Practice Cost Index
Question 29: GPCI is used to.
Answer: realize the varying cost based on geographic location
Question 30: HCPCS.
Answer: Healthcare Common Procedure Coding System
Page 3
A+)
Question 1: A compliance plan may offer several benefits, including:.
Answer: * more accurate payment of claims * fewer billing mistakes * improved documentation and more
accurate coding * less chance of violating self-referral and anti-kickback status
Question 2: A healthcare clearing house is a.
Answer: entity that processes nonstandard health information they receive from another entity into a
standard format
Question 3: A key provision in HIPAA is the Minimum Necessary requirement. this means.
Answer: only the minimum necessary protected health information should be shared to satisfy a particular
purpose.
Question 4: A medically necessary service is the.
Answer: least radical service/procedure that allows for effective treatment of the patients' complaint or
condition
Question 5: A patient sustaining an injury to her great saphenous vein would have sustained injury to
which of anatomical site?
Answer: Leg
Question 6: APC.
Answer: Ambulatory Payment Classification
Question 7: ARRA.
Answer: American Recovery and Reinvestment Act (of 2009)
Question 8: ASC.
Answer: Ambulatory Surgical Centers
Question 9: Abuse consists of.
Answer: payment for items or services that are billed by providers in error that should not be paid for by
Medicare.
Page 1
,Question 10: An ABN protects the provider's financial interest by.
Answer: creating a paper trail that CMS requires before a provider can bill the patient for payment if
Medicare denies coverage for the stated service or procedure.
Question 11: An entity that processes nonstandard health information they receive from another entity
into a standard format is considered what?
Answer: Clearinghouse
Question 12: As a part of Health Care Reform, the Affordable Care Act of 2010 amended the definition
of fraud to remove the __________ requirement.
Answer: intent
Question 13: By statute, all work RVUs, must be examined no less often than.
Answer: every 5 years
Question 14: CF.
Answer: Coversion Factor - fixed dollar amount used to translate the RVUs into fees
Question 15: CMS.
Answer: Centers for Medicare and Medicaid
Question 16: CMS developed polices regarding medical necessity are based on regulations found in title
XVIII, $1862(a) of the.
Answer: Social Security Act
Question 17: CMS will accept the ____________ for either a "potentially non=covered" service or for a
statutorily excluded service.
Answer: CMS-R-131
Question 18: CMS-R-131.
Answer: ABN form or Advance Beneficiary Notice which explains to the patient why Medicare may deny
the particular service or procedure.
Question 19: CPT.
Answer: Current Procedural Terminology
Page 2
, Question 20: CY 2013 Conversion Factor.
Answer: $25.0008
Question 21: Commercial (non-Medicare) may develop their own medical policies which do not follow
Medicare guidelines and are specified in.
Answer: private contracts between the payer and practice or provider
Question 22: DRG.
Answer: Diagnosis Related Group
Question 23: Does Medicare Part B generally require a yearly deductable and copayment?
Answer: yes
Question 24: E/M OR E&M.
Answer: Evaluation and Management
Question 25: EHR.
Answer: Electronic Health Record
Question 26: Formula for Calculating Facility Payment amounts.
Answer: [(Work RVU * Work GPCI) + (Transitioned Facility PE RVU * PE GPCI) + (MP RVU * MP
GPCI)] * CF
Question 27: Formula for Non-Facility Pricing Amount.
Answer: [(Work RVU * Work GPCI) + (Transitioned Non-Facility PE RVU * PE GPCI) + (MP RVU * MP
GPCI)] * (CF)
Question 28: GPCI.
Answer: Geographic Practice Cost Index
Question 29: GPCI is used to.
Answer: realize the varying cost based on geographic location
Question 30: HCPCS.
Answer: Healthcare Common Procedure Coding System
Page 3
