AAPC Official CPC Certification EXAM COMPREHENSIVE QUESTIONS AND VERIFIED ANSWERS (DETAILED & ELABORATED) ACTUAL EXAM 2025 TEST 100% SOLVED 2025!!

5/3/25, 6:25 AM AAPC Official CPC Certification EXAM COMPREHENSIVE QUESTIONS AND VERIFIED ANSWERS (DETAILED & ELABORATED) …




AAPC Official CPC Certification EXAM
COMPREHENSIVE QUESTIONS AND VERIFIED
ANSWERS (DETAILED & ELABORATED) ACTUAL
EXAM 2025 TEST 100% SOLVED 2025!!

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Terms in this set (156)


* found in some non-Medicare health plan contracts
"hold harmless clause" * prohibits billing to patient for anything beyond
deductibles and co-pays.

* more accurate payment of claims
A compliance plan may * fewer billing mistakes
offer several benefits, * improved documentation and more accurate coding
including: * less chance of violating self-referral and anti-
kickback status

entity that processes nonstandard health information
A healthcare clearing
they receive from another entity into a standard
house is a
format

A key provision in HIPAA is only the minimum necessary protected health
the Minimum Necessary information should be shared to satisfy a particular
requirement. this means purpose.

least radical service/procedure that allows for
A medically necessary
effective treatment of the patients' complaint or
service is the
condition




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,5/3/25, 6:25 AM AAPC Official CPC Certification EXAM COMPREHENSIVE QUESTIONS AND VERIFIED ANSWERS (DETAILED & ELABORATED) …


A patient sustaining an Leg
injury to her great
saphenous vein would
have sustained injury to
which of anatomical site?

APC Ambulatory Payment Classification

ARRA American Recovery and Reinvestment Act (of 2009)

ASC Ambulatory Surgical Centers

payment for items or services that are billed by
Abuse consists of providers in error that should not be paid for by
Medicare.

An ABN protects the creating a paper trail that CMS requires before a
provider's financial interest provider can bill the patient for payment if Medicare
by denies coverage for the stated service or procedure.

An entity that processes Clearinghouse
nonstandard health
information they receive
from another entity into a
standard format is
considered what?

As a part of Health Care intent
Reform, the Affordable
Care Act of 2010 amended
the definition of fraud to
remove the __________
requirement

By statute, all work RVUs, every 5 years
must be examined no less
often than

Coversion Factor - fixed dollar amount used to
CF
translate the RVUs into fees

CMS Centers for Medicare and Medicaid

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CMS developed polices Social Security Act
regarding medical
necessity are based on
regulations found in title
XVIII, $1862(a) of the

CMS will accept the CMS-R-131
____________ for either a
"potentially non=covered"
service or for a statutorily
excluded service

ABN form


or
CMS-R-131
Advance Beneficiary Notice which explains to the
patient why Medicare may deny the particular service
or procedure.

CPT Current Procedural Terminology

CY 2013 Conversion $25.0008
Factor

Commercial (non- private contracts between the payer and practice or
Medicare) may develop provider
their own medical policies
which do not follow
Medicare guidelines and
are specified in

DRG Diagnosis Related Group

Does Medicare Part B yes
generally require a yearly
deductable and
copayment?

E/M OR E&M Evaluation and Management

EHR Electronic Health Record
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