AAPC CPC Compliance and Regulatory
Exam Questions With 100% Verified
Answers
What document is referenced to when looking for
potentialproblem areas identified by the government
indicatingscrutiny of the services within the coming year?:
A) OIG Compliance Plan Guidance
B) OIG Security Summary
C) OIG Work Plan
D) OIG Investigation Plan -
correct answer ✅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 form is provided to a patient to indicate a servicemay not be
covered by Medicare and the patient may be responsible for the
charges?:
A) LCD
B) CMS-1500
C) UB-04
D) ABN -
correct answer ✅D (Rationale: An Advanced Beneficiary Notice
(ABN) is used when a Medicare beneficiary requests or agrees to
,AAPC CPC Compliance and Regulatory
Exam Questions With 100% Verified
Answers
receive a procedure or service that Medicare may not cover. This
form notifies the patient of potential out of pocket costs for the
patient.)
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. -
correct answer ✅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.)
Which statement describes a medically necessary service? :
, AAPC CPC Compliance and Regulatory
Exam Questions With 100% Verified
Answers
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. -
correct answer ✅B (Rationale: Medical necessity is using the least
radical services/procedure that allows for effective treatment of the
patient's complaint or condition.)
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 -
correct answer ✅B (Rationale: According to the LCD, Chronic
venous insufficiency is a systemic condition that may result in the
need for routine foot care.)
Exam Questions With 100% Verified
Answers
What document is referenced to when looking for
potentialproblem areas identified by the government
indicatingscrutiny of the services within the coming year?:
A) OIG Compliance Plan Guidance
B) OIG Security Summary
C) OIG Work Plan
D) OIG Investigation Plan -
correct answer ✅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 form is provided to a patient to indicate a servicemay not be
covered by Medicare and the patient may be responsible for the
charges?:
A) LCD
B) CMS-1500
C) UB-04
D) ABN -
correct answer ✅D (Rationale: An Advanced Beneficiary Notice
(ABN) is used when a Medicare beneficiary requests or agrees to
,AAPC CPC Compliance and Regulatory
Exam Questions With 100% Verified
Answers
receive a procedure or service that Medicare may not cover. This
form notifies the patient of potential out of pocket costs for the
patient.)
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. -
correct answer ✅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.)
Which statement describes a medically necessary service? :
, AAPC CPC Compliance and Regulatory
Exam Questions With 100% Verified
Answers
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. -
correct answer ✅B (Rationale: Medical necessity is using the least
radical services/procedure that allows for effective treatment of the
patient's complaint or condition.)
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 -
correct answer ✅B (Rationale: According to the LCD, Chronic
venous insufficiency is a systemic condition that may result in the
need for routine foot care.)
