AAPC CPC Chapter 1 Exam Questions
and Answers 100% Solved | Rated A+
C (Rationale: Twice a year, the OIG releases a Work Plan outlining its
priorities for the fiscal year ahead. Within the Work Plan, potential problem
areas with claims submissions are listed and will be targeted with special
scrutiny.) - ✔✔What document is referenced to when looking for potential
problem areas identified by the government indicating scrutiny of the
services within the coming year?:
A) OIG Compliance Plan Guidance
B) OIG Security Summary
C) OIG Work Plan
D) OIG Investigation Plan
D (Rationale: An Advanced Beneficiary Notice (ABN) is used when a
Medicare beneficiary requests or agrees to receive a procedure or service
that Medicare may not cover. This form notifies the patient of potential out
of pocket costs for the patient.) - ✔✔What form is provided to a patient to
1
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
,indicate a service may not be covered by Medicare and the patient may be
responsible for the charges?:
A) LCD
B) CMS-1500
C) UB-04
D) ABN
A (Rationale: It is the responsibility of a covered entity to develop and
implement policies, best suited to its particular circumstances to meet
HIPAA requirements. As a policy requirement, only those individuals whose
job requires it may have access to protected health information.) -
✔✔Under HIPAA, what would be a policy requirement for "minimum
necessary"? "
A) Only individuals whose job requires it may have access to protected
health information.
B) Only the patient has access to his or her own protected health
information.
C) Only the treating provider has access to protected health information.
D) Anyone within the provider's office can have access to protected health
information.
2
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
, B (Rationale: Medical necessity is using the least radical
services/procedure that allows for effective treatment of the patient's
complaint or condition.) - ✔✔Which statement describes a medically
necessary service? :
A) Performing a procedure/service based on cost to eliminate wasteful
services.
B) Using the least radical service/procedure that allows for effective
treatment of the patient's complaint or condition.
C) Using the closest facility to perform a service or procedure.
D) Using the appropriate course of treatment to fit within the patient's
lifestyle.
C (Rationale: According to the LCD, Chronic venous insufficiency is a
systemic condition that may result in the need for routine foot care.) -
✔✔According to the example LCD from Novitas Solutions, which of the
following conditions is considered a systemic condition that may result in
the need for routine foot care? :
A) arthritis
B) chronic venous insufficiency
C) hypertension
D) muscle weakness
3
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
and Answers 100% Solved | Rated A+
C (Rationale: Twice a year, the OIG releases a Work Plan outlining its
priorities for the fiscal year ahead. Within the Work Plan, potential problem
areas with claims submissions are listed and will be targeted with special
scrutiny.) - ✔✔What document is referenced to when looking for potential
problem areas identified by the government indicating scrutiny of the
services within the coming year?:
A) OIG Compliance Plan Guidance
B) OIG Security Summary
C) OIG Work Plan
D) OIG Investigation Plan
D (Rationale: An Advanced Beneficiary Notice (ABN) is used when a
Medicare beneficiary requests or agrees to receive a procedure or service
that Medicare may not cover. This form notifies the patient of potential out
of pocket costs for the patient.) - ✔✔What form is provided to a patient to
1
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
,indicate a service may not be covered by Medicare and the patient may be
responsible for the charges?:
A) LCD
B) CMS-1500
C) UB-04
D) ABN
A (Rationale: It is the responsibility of a covered entity to develop and
implement policies, best suited to its particular circumstances to meet
HIPAA requirements. As a policy requirement, only those individuals whose
job requires it may have access to protected health information.) -
✔✔Under HIPAA, what would be a policy requirement for "minimum
necessary"? "
A) Only individuals whose job requires it may have access to protected
health information.
B) Only the patient has access to his or her own protected health
information.
C) Only the treating provider has access to protected health information.
D) Anyone within the provider's office can have access to protected health
information.
2
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
, B (Rationale: Medical necessity is using the least radical
services/procedure that allows for effective treatment of the patient's
complaint or condition.) - ✔✔Which statement describes a medically
necessary service? :
A) Performing a procedure/service based on cost to eliminate wasteful
services.
B) Using the least radical service/procedure that allows for effective
treatment of the patient's complaint or condition.
C) Using the closest facility to perform a service or procedure.
D) Using the appropriate course of treatment to fit within the patient's
lifestyle.
C (Rationale: According to the LCD, Chronic venous insufficiency is a
systemic condition that may result in the need for routine foot care.) -
✔✔According to the example LCD from Novitas Solutions, which of the
following conditions is considered a systemic condition that may result in
the need for routine foot care? :
A) arthritis
B) chronic venous insufficiency
C) hypertension
D) muscle weakness
3
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
