CPPM Exam Prep (AAPC Practice Management Final
Exam) – Questions And Answers
Revenue Per Visit (RPV) Right Ans - Total amount collected divides by the
total number of patient visits
Advance Benefit Notification (ABN) Right Ans - Notification given to
patients advising Medicare may not cover a certain procedure or service
Payment for fee for service is based on Right Ans - CPT & HCPCS Level II
MCO Right Ans - Private Health Plan
Place of Service (POS) determines correct reimbursement when Right Ans -
The professional component for services provided in a facility (I.e. HOD) are
less than when provided in a physician office as the physician doesn't have
any practice expense at the facility. (In private practice they pay rent, staff etc
whereas is HOD these are paid by the facility)
DEA number Right Ans - Is not needed for the online application to CMS for
an NPI
Customer service, optimizing physician time and claim quality assurance are
key components to which role? Right Ans - Front Desk
What can result in claim denial? Right Ans - Incorrect POS, incorrect NPI,
and a truncated diagnosis code
Patients are prepared to make payments at the time of there visits when?
Right Ans - Payment & collection policies are prominently posted in the office
What is the most important criteria to meet for the selection of Evaluation and
Management (E/M) codes? Right Ans - Medical necessity
What code set represents healthcare equipment, drugs and supplies? Right
Ans - ICD-10.PCS
, ICD-10-CM Right Ans - International Classification of Diseases, Tenth
Revision, Clinical Modification CM codes represent the diagnosis/reason a
service is performed.
ICD-10-PCS Right Ans - International Classification of Diseases, Revision
Procedural Coding System. These represent procedures performed at
inpatient hospital facilities
CPT codes Right Ans - current procedural terminology represent
procedures performed & bilked by physicians and non-physicians
practitioners (APP's)
HCPCS Level II Right Ans - for products and supplies and services not
included in level I. the code is alphanumeric
Clean Claim Form Right Ans - A form that is complete and accurate and
includes all provider information and other additional information to process
for payment
History of present illness Right Ans - Chronological description of the
development of patients complaint
Which codes are used by physicians and APP's to report professional services?
Right Ans - CPT & HCPCS Level Ii
Procedure codes are reported using which codes? Right Ans - CPT
Medicare patient with Parts A, B & C and no fault auto insurance is seen in the
ED following a minor auto accident, who is the primary insurance? Right
Ans - Auto No-Fault
What is the first thing to review when a private payer repeatedly denies a
specific code (o.e. Venipuncture)? Right Ans - Payer Contract to see if
denial is appropriate
Vital component of medical coding Right Ans - Codes based on complete
and accurate medical record documentation in the patients chart
Exam) – Questions And Answers
Revenue Per Visit (RPV) Right Ans - Total amount collected divides by the
total number of patient visits
Advance Benefit Notification (ABN) Right Ans - Notification given to
patients advising Medicare may not cover a certain procedure or service
Payment for fee for service is based on Right Ans - CPT & HCPCS Level II
MCO Right Ans - Private Health Plan
Place of Service (POS) determines correct reimbursement when Right Ans -
The professional component for services provided in a facility (I.e. HOD) are
less than when provided in a physician office as the physician doesn't have
any practice expense at the facility. (In private practice they pay rent, staff etc
whereas is HOD these are paid by the facility)
DEA number Right Ans - Is not needed for the online application to CMS for
an NPI
Customer service, optimizing physician time and claim quality assurance are
key components to which role? Right Ans - Front Desk
What can result in claim denial? Right Ans - Incorrect POS, incorrect NPI,
and a truncated diagnosis code
Patients are prepared to make payments at the time of there visits when?
Right Ans - Payment & collection policies are prominently posted in the office
What is the most important criteria to meet for the selection of Evaluation and
Management (E/M) codes? Right Ans - Medical necessity
What code set represents healthcare equipment, drugs and supplies? Right
Ans - ICD-10.PCS
, ICD-10-CM Right Ans - International Classification of Diseases, Tenth
Revision, Clinical Modification CM codes represent the diagnosis/reason a
service is performed.
ICD-10-PCS Right Ans - International Classification of Diseases, Revision
Procedural Coding System. These represent procedures performed at
inpatient hospital facilities
CPT codes Right Ans - current procedural terminology represent
procedures performed & bilked by physicians and non-physicians
practitioners (APP's)
HCPCS Level II Right Ans - for products and supplies and services not
included in level I. the code is alphanumeric
Clean Claim Form Right Ans - A form that is complete and accurate and
includes all provider information and other additional information to process
for payment
History of present illness Right Ans - Chronological description of the
development of patients complaint
Which codes are used by physicians and APP's to report professional services?
Right Ans - CPT & HCPCS Level Ii
Procedure codes are reported using which codes? Right Ans - CPT
Medicare patient with Parts A, B & C and no fault auto insurance is seen in the
ED following a minor auto accident, who is the primary insurance? Right
Ans - Auto No-Fault
What is the first thing to review when a private payer repeatedly denies a
specific code (o.e. Venipuncture)? Right Ans - Payer Contract to see if
denial is appropriate
Vital component of medical coding Right Ans - Codes based on complete
and accurate medical record documentation in the patients chart
