Notes, definitions and questions from
AAPC CPCMedical Coding̣ Prep 2026
Terms in this set (156)
"hold harmless clause"* found in some non- Medicare health plan contracts
* prohibits billing̣ to patient for anything̣ beyond
deductibles and co-pays.
A compliance accurate payment of claims benefits,
plan may offer
including̣:* fewer billing̣ mistakes
*improved documentation and more
accuratecoding̣
*less chance of violating̣ self-referral and anti-
kickback status
A healthcare clearing̣ house is aentity that processes nonstandard health information they
receive from another entity into a standard format
A key provision in HIPAA is theonly the minimum necessary protected health Minimum
Necessary requirement. thisinformation should be shared to satisfy a particular
meanspurpose.
, A medically necessary service is theleast radical service/procedure that allows for effective
treatment of the patients' complaint or condition
A patient sustaining̣ an injury to herLeg̣
g̣reat
saphenous vein would have sustained injury
to which of anatomical site?
APC Ambulatory Payment Classification
ARRAAmerican Recovery and Reinvestment Act (of
2009)
ASC Ambulatory Surg̣ical Centers
Abuse consists ofpayment for items or services that are billed by
providers in error that should not be paid for by
Medicare.
An ABN protects the provider'screating̣ a paper trail that CMS requires before a financial
interest byprovider can bill the patient for payment if
Medicare denies coverag̣e for the stated service or
procedure.
An entity that processesClearing̣house
nonstandard health information they
receive from another entity into a standard
format is considered what?