AAPC Certified Anesthesia and Pain Management Coder (CANPC)™ certification Notes, definitions and questions from AAPC CPC Study Guide Medical Coding Prep 2025 American Academy of Professional Coders

AAPC Certified Anesthesia and Pain Management Coder (CANPC)™ certification Notes,
definitions and questions from AAPC CPC Study Guide Medical Coding Prep 2025 American
Academy of Professional Coders"holdharmless clause" - * found in somenon-Medicare l0 l0 l0 l0 l0 l0 l0 l0




health plan contracts l0 l0 l0




* prohibits billingto patientforanythingbeyonddeductibles and co-pays.
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A compliance planmay offer severalbenefits, including: -* more accuratepayment of claims
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* fewerbilling mistakes
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* improved documentation and moreaccurate coding
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* lesschance ofviolatingself-referralandanti-kickback status
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A healthcareclearing house isa -entitythatprocesses nonstandard healthinformation they receive
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from another entity into a standard format
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A key provision in HIPAA is the Minimum Necessary requirement. this means - only the minimum
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necessaryprotectedhealthinformation should be sharedtosatisfy a particular purpose.
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A medically necessary service is the - least radicalservice/procedure thatallows for effective
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treatment of the patients' complaint or condition
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A patient sustainingan injury tohergreat saphenous vein wouldhavesustained injury towhich of
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anatomical site? - Leg
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APC - Ambulatory Payment Classification
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ARRA-American RecoveryandReinvestment Act(of2009) ASC -
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l0 Ambulatory Surgical Centers l0 l0




Abuseconsists of -payment for itemsor services that arebilled byproviders in error that should
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not be paid for by Medicare.
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An ABN protectstheprovider's financialinterest by -creating a papertrailthat CMS requires before
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a provider can bill the patient for payment if Medicare denies coverage for the stated service or
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procedure.
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An entitythatprocessesnonstandardhealthinformation theyreceivefrom anotherentity into a
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standard format is considered what? - Clearinghouse
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, As a part of Health Care Reform, the Affordable Care Act of 2010 amended the definition of fraud
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to remove the
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By statute, all work RVUs, must be examined no less often than - every 5 years CF -
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Coversion Factor - fixed dollar amount used to translate the RVUs into fees CMS -
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l0 Centers for Medicare and Medicaid l0 l0 l0 l0




CMS developed polices regardingmedical necessityare based on regulations found in title XVIII,
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$1862(a) ofthe - SocialSecurity Act l0 l0 l0 l0 l0 l0




CMS will accept the for either a"potentiallynon=covered"service orfora
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statutorily excluded service - CMS-R-131
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CMS-R-131 - ABN form l0 l0 l0




or



AdvanceBeneficiaryNoticewhich explainsto the patientwhy Medicaremay denythe l0 l0 l0 l0 l0 l0 l0 l0 l0 l0 l0 l0




particular service or procedure.
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CPT-CurrentProceduralTerminology CY
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2013 Conversion Factor - $25.0008
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Commercial (non-Medicare) may develop their own medical policies which do not follow Medicare l0 l0 l0 l0 l0 l0 l0 l0 l0 l0 l0 l0




guidelines andare specified in -privatecontractsbetweenthepayerand practice or provider
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DRG -Diagnosis Related Group l0 l0 l0 l0




DoesMedicare Part Bgenerallyrequirea yearly deductableandcopayment? -yes E/M OR
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l0 E&M - Evaluation and Management l0 l0 l0 l0




EHR - Electronic Health Record
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FormulaforCalculatingFacility Payment amounts -[(Work RVU * Work GPCI)+ (Transitioned Facility
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PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * CF
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