AAPC Official CPC Certification EXAM
COMPREHENSIVE QUESTIONS AND VERIFIED
ANSWERS (DETAILED & ELABORATED) ACTUAL
EXAM 2025 TEST 100% SOLVED 2025!!
"hold harmless clause" - (ANSWER)* 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: - (ANSWER)* 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 - (ANSWER)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 -
(ANSWER)only the minimum necessary protected health information should be
shared to satisfy a particular purpose.
A medically necessary service is the - (ANSWER)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? - (ANSWER)Leg
APC - (ANSWER)Ambulatory Payment Classification
ARRA - (ANSWER)American Recovery and Reinvestment Act (of 2009)
ASC - (ANSWER)Ambulatory Surgical Centers
Abuse consists of - (ANSWER)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 - (ANSWER)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? -
(ANSWER)Clearinghouse
As a part of Health Care Reform, the Affordable Care Act of 2010 amended the
definition of fraud to remove the __________ requirement - (ANSWER)intent
, By statute, all work RVUs, must be examined no less often than - (ANSWER)every
5 years
CF - (ANSWER)Coversion Factor - fixed dollar amount used to translate the RVUs
into fees
CMS - (ANSWER)Centers for Medicare and Medicaid
CMS developed polices regarding medical necessity are based on regulations
found in title XVIII, $1862(a) of the - (ANSWER)Social Security Act
CMS will accept the ____________ for either a "potentially non=covered" service
or for a statutorily excluded service - (ANSWER)CMS-R-131
CMS-R-131 - (ANSWER)ABN form
or
Advance Beneficiary Notice which explains to the patient why Medicare may deny
the particular service or procedure.
CPT - (ANSWER)Current Procedural Terminology
COMPREHENSIVE QUESTIONS AND VERIFIED
ANSWERS (DETAILED & ELABORATED) ACTUAL
EXAM 2025 TEST 100% SOLVED 2025!!
"hold harmless clause" - (ANSWER)* 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: - (ANSWER)* 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 - (ANSWER)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 -
(ANSWER)only the minimum necessary protected health information should be
shared to satisfy a particular purpose.
A medically necessary service is the - (ANSWER)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? - (ANSWER)Leg
APC - (ANSWER)Ambulatory Payment Classification
ARRA - (ANSWER)American Recovery and Reinvestment Act (of 2009)
ASC - (ANSWER)Ambulatory Surgical Centers
Abuse consists of - (ANSWER)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 - (ANSWER)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? -
(ANSWER)Clearinghouse
As a part of Health Care Reform, the Affordable Care Act of 2010 amended the
definition of fraud to remove the __________ requirement - (ANSWER)intent
, By statute, all work RVUs, must be examined no less often than - (ANSWER)every
5 years
CF - (ANSWER)Coversion Factor - fixed dollar amount used to translate the RVUs
into fees
CMS - (ANSWER)Centers for Medicare and Medicaid
CMS developed polices regarding medical necessity are based on regulations
found in title XVIII, $1862(a) of the - (ANSWER)Social Security Act
CMS will accept the ____________ for either a "potentially non=covered" service
or for a statutorily excluded service - (ANSWER)CMS-R-131
CMS-R-131 - (ANSWER)ABN form
or
Advance Beneficiary Notice which explains to the patient why Medicare may deny
the particular service or procedure.
CPT - (ANSWER)Current Procedural Terminology
