AAPC OFFICIAL CPC
CERTIFICATION EXAM GUIDE
2024/2025 |GUARANTEED PASS
"hold harmless clause" - ✔✔correct * found in some non-Medicare
health plan contracts
* prohibits billing to patient for anything beyond deductibles and co-
pays.
A compliance plan may offer several benefits, including: - ✔✔correct *
more accurate payment of claims
* fewer billing mistakes
* improved documentation and more accurate coding
* less chance of violating self-referral and anti-kickback status
A healthcare clearing house is a - ✔✔correct entity that processes
nonstandard health information they receive from another entity into a
standard format
A key provision in HIPAA is the Minimum Necessary requirement. This
means - ✔✔correct only the minimum necessary protected health
information should be shared to satisfy a particular purpose.
A medically necessary service is the - ✔✔correct least radical
service/procedure that allows for effective treatment of the patients'
complaint or condition
,A patient sustaining an injury to her great saphenous vein would have
sustained injury to which of anatomical site? - ✔✔correct Leg
APC - ✔✔correct Ambulatory Payment Classification
ARRA - ✔✔correct American Recovery and Reinvestment Act (of
2009)
ASC - ✔✔correct Ambulatory Surgical Centers
Abuse consists of - ✔✔correct payment for items or services that are
billed by providers in error that should not be paid for by Medicare.
An ABN protects the provider's financial interest by - ✔✔correct
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.
An entity that processes nonstandard health information they receive
from another entity into a standard format is considered what? -
✔✔correct Clearinghouse
As a part of Health Care Reform, the Affordable Care Act of 2010
amended the definition of fraud to remove the __________ requirement
- ✔✔correct intent
, By statute, all work rvus, must be examined no less often than -
✔✔correct every 5 years
CF - ✔✔correct Coversion Factor - fixed dollar amount used to translate
the rvus into fees
CMS - ✔✔correct Centers for Medicare and Medicaid
CMS developed polices regarding medical necessity are based on
regulations found in title XVIII, $1862(a) of the - ✔✔correct Social
Security Act
CMS will accept the ____________ for either a "potentially
non=covered" service or for a statutorily excluded service - ✔✔correct
CMS-R-131
CMS-R-131 - ✔✔correct ABN form
Or
Advance Beneficiary Notice which explains to the patient why Medicare
may deny the particular service or procedure.
CPT - ✔✔correct Current Procedural Terminology
CERTIFICATION EXAM GUIDE
2024/2025 |GUARANTEED PASS
"hold harmless clause" - ✔✔correct * found in some non-Medicare
health plan contracts
* prohibits billing to patient for anything beyond deductibles and co-
pays.
A compliance plan may offer several benefits, including: - ✔✔correct *
more accurate payment of claims
* fewer billing mistakes
* improved documentation and more accurate coding
* less chance of violating self-referral and anti-kickback status
A healthcare clearing house is a - ✔✔correct entity that processes
nonstandard health information they receive from another entity into a
standard format
A key provision in HIPAA is the Minimum Necessary requirement. This
means - ✔✔correct only the minimum necessary protected health
information should be shared to satisfy a particular purpose.
A medically necessary service is the - ✔✔correct least radical
service/procedure that allows for effective treatment of the patients'
complaint or condition
,A patient sustaining an injury to her great saphenous vein would have
sustained injury to which of anatomical site? - ✔✔correct Leg
APC - ✔✔correct Ambulatory Payment Classification
ARRA - ✔✔correct American Recovery and Reinvestment Act (of
2009)
ASC - ✔✔correct Ambulatory Surgical Centers
Abuse consists of - ✔✔correct payment for items or services that are
billed by providers in error that should not be paid for by Medicare.
An ABN protects the provider's financial interest by - ✔✔correct
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.
An entity that processes nonstandard health information they receive
from another entity into a standard format is considered what? -
✔✔correct Clearinghouse
As a part of Health Care Reform, the Affordable Care Act of 2010
amended the definition of fraud to remove the __________ requirement
- ✔✔correct intent
, By statute, all work rvus, must be examined no less often than -
✔✔correct every 5 years
CF - ✔✔correct Coversion Factor - fixed dollar amount used to translate
the rvus into fees
CMS - ✔✔correct Centers for Medicare and Medicaid
CMS developed polices regarding medical necessity are based on
regulations found in title XVIII, $1862(a) of the - ✔✔correct Social
Security Act
CMS will accept the ____________ for either a "potentially
non=covered" service or for a statutorily excluded service - ✔✔correct
CMS-R-131
CMS-R-131 - ✔✔correct ABN form
Or
Advance Beneficiary Notice which explains to the patient why Medicare
may deny the particular service or procedure.
CPT - ✔✔correct Current Procedural Terminology
