CPC Certification Study Guide questions and answers
2026\2027 A+ Grade
When should an ABN be signed?
- correct answer When a service is not expected to be covered by Medicare.
What are NCD's interpreted at the MAC level considered?
- correct answer LCD
What is medical billing?
- correct answer Translating medical documentation into codes.
What part of Medicare should be billed for the pain medication by the pharmacy?
- correct answer Part D
The amount on an ABN should be within how much of the cost to the patient?
- correct answer $100 or 25% of cost.
An entity that processes nonstandard health information they receive from another entity into a
standard is considered what?
- correct answer Clearinghouse.
What is PHI?
- correct answer Personal Health Information.
Intentional billing of services not provided is considered?
- correct answer Fraud.
What OIG document should a provider reveiw for potential problem areas that will receive special
scrutiny in the upcoming year?
- correct answer OIG Work Plan. Each year in October.
,What is ABN?
- correct answer Advance Beneficiary Notification
What is AMA?
- correct answer American Medical Association.
What is CPC?
- correct answer Current Procedural Terminology. What was done into codes.
What is ICD-9-CM?
- correct answer International Classification of Disease, 9th Clinical Modification. Why was done in
codes.
What is HIPAA?
- correct answer Health Insurance Portability and Accountability Act of 1996. Law passed by Congress to
improve the portability and continuity of healthcare coverage.
What is OIG?
- correct answer Office of Inspector General. Makes sure everyone is in compliance
What is CMS?
- correct answer Centers for Medicare & Medicaid Services. Basic guidelines for private prctice and rules.
a-,an-
- correct answer Without, lack of, absent, deficient
Ab-,abs-
- correct answer From, away
Ad-
- correct answer Near, toward
, -algia,-algesia
- correct answer Pain
Ambi-
- correct answer Both
Angio
- correct answer Vessle (blood or lymph)
Ano
- correct answer Anus
Ante-
- correct answer Before
Anti-
- correct answer Against
Arterio
- correct answer Artery
Arthro
- correct answer Joint
Asthenia
- correct answer Weakness.
Auto-
- correct answer Self
Bi-
- correct answer Two, twice
2026\2027 A+ Grade
When should an ABN be signed?
- correct answer When a service is not expected to be covered by Medicare.
What are NCD's interpreted at the MAC level considered?
- correct answer LCD
What is medical billing?
- correct answer Translating medical documentation into codes.
What part of Medicare should be billed for the pain medication by the pharmacy?
- correct answer Part D
The amount on an ABN should be within how much of the cost to the patient?
- correct answer $100 or 25% of cost.
An entity that processes nonstandard health information they receive from another entity into a
standard is considered what?
- correct answer Clearinghouse.
What is PHI?
- correct answer Personal Health Information.
Intentional billing of services not provided is considered?
- correct answer Fraud.
What OIG document should a provider reveiw for potential problem areas that will receive special
scrutiny in the upcoming year?
- correct answer OIG Work Plan. Each year in October.
,What is ABN?
- correct answer Advance Beneficiary Notification
What is AMA?
- correct answer American Medical Association.
What is CPC?
- correct answer Current Procedural Terminology. What was done into codes.
What is ICD-9-CM?
- correct answer International Classification of Disease, 9th Clinical Modification. Why was done in
codes.
What is HIPAA?
- correct answer Health Insurance Portability and Accountability Act of 1996. Law passed by Congress to
improve the portability and continuity of healthcare coverage.
What is OIG?
- correct answer Office of Inspector General. Makes sure everyone is in compliance
What is CMS?
- correct answer Centers for Medicare & Medicaid Services. Basic guidelines for private prctice and rules.
a-,an-
- correct answer Without, lack of, absent, deficient
Ab-,abs-
- correct answer From, away
Ad-
- correct answer Near, toward
, -algia,-algesia
- correct answer Pain
Ambi-
- correct answer Both
Angio
- correct answer Vessle (blood or lymph)
Ano
- correct answer Anus
Ante-
- correct answer Before
Anti-
- correct answer Against
Arterio
- correct answer Artery
Arthro
- correct answer Joint
Asthenia
- correct answer Weakness.
Auto-
- correct answer Self
Bi-
- correct answer Two, twice
