AAPC Chapter 1-The Business of Medicine

AAPC Chapter 1-The Business of Medicine Which statement describes a medically necessary service? - ☑Using the least radical service/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? - ☑Chronic venous insufficiency What form is provided to a patient to indicate a service may not be covered by Medicare and that patient may be responsible for the charges? - ☑ABN What is true regarding ABN's? - ☑ABN's may not be recognized by non-Medicare payers. When presenting a cost estimate on an ABN for a potentially non-covered service, the cost estimate should be within what range of the actual cost? - ☑$100 or 25% Who would NOT be considered a covered entity under HIPAA? - ☑Patients Under HIPAA, what would be a policy requirement for minimum necessary? - ☑Only individuals whose job requires it may have access to protected health information Which Act was enacted as part of the American Recovery and Reinvestment Act (ARRA) of 2009 and affected privacy and security? - ☑HITECH What document assists provider offices with the development of compliance manuals? - ☑OIG Compliance Plan Guidance What document is referenced when looking for potential problem areas identified by the government indicating scrutiny of the services within the coming year? - ☑OIG Work Plan What type of profession, other than coding, might skilled coders enter? - ☑Consultants, educators, and medical auditors What is the difference between outpatient and inpatient coding? - ☑Inpatient coders use ICD-10-CM and ICD-10-PCS What is a mid-level provider? - ☑Physician assistants (PA) and nurse practitioners (NP) What are the different parts of Medicare? - ☑Parts A,B,C, and D Evaluation and Management (E/M) services are often provided and documented in a standard SOAP format. What does SOAP represent? - ☑Subjective