CPC CERTIFICATION EXAM STUDY GUIDE QUESTIONS WITH
FULLY SOLVED ANSWERS.
1) What is Part A? -- Answer ✔✔ Medicares's Hospital Insurance; covers hospital/facility
_ _ _ _ _ _ _ _ _ _ _
care.
_
2) What is Part B? -- Answer ✔✔ Medicare's Supplemental Medical Insurance; covers
_ _ _ _ _ _ _ _ _ _ _ _
physician services and durable medical equipment that are not paid for under Part A.
_ _ _ _ _ _ _ _ _ _ _ _ _
3) What is Part C? -- Answer ✔✔ Medicare's Advantage is a set of health care options
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
from which beneficiaries choose health care providers.
_ _ _ _ _ _
4) What is Part D? -- Answer ✔✔ Medicare's prescription drug program.
_ _ _ _ _ _ _ _ _ _
5) What is WHO? -- Answer ✔✔ World Health Organization. A group that deals with
_ _ _ _ _ _ _ _ _ _ _ _ _ _
health care issues on a global basis.
_ _ _ _ _ _
6) Volume 1 of ICD-9-CM contains what? -- Answer ✔✔ Tabular List: Diagnosis codes
_ _ _ _ _ _ _ _ _ _ _ _ _
organized in order by code. _ _ _ _
7) Volume 2 of ICD-9-CM contains what? -- Answer ✔✔ Index to Diseases: Diagnosis
_ _ _ _ _ _ _ _ _ _ _ _ _
codes organized in an alphabetic index.
_ _ _ _ _
8) Volume 3 of ICD-9-VM contains what? -- Answer ✔✔ Alphabetic Index and Tabular
_ _ _ _ _ _ _ _ _ _ _ _ _
Index of Procedures: Procedures performed in the inpatient setting.
_ _ _ _ _ _ _ _
9) V codes -- Answer ✔✔ Codes used to describe circumstances or condition that
_ _ _ _ _ _ _ _ _ _ _ _ _
could influence patient care.
_ _ _
, 10) When should an ABN be signed? -- Answer ✔✔ When a service is not expected to
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
be covered by Medicare.
_ _ _
11) What are NCD's interpreted at the MAC level considered? -- Answer ✔✔ LCD
_ _ _ _ _ _ _ _ _ _ _ _
12) What is medical billing? -- Answer ✔✔ Translating medical documentation into codes.
_ _ _ _ _ _ _ _ _ _ _
13) What part of Medicare should be billed for the pain medication by the pharmacy? --
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Answer ✔✔ Part D _ _ _
14) The amount on an ABN should be within how much of the cost to the patient? --
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Answer ✔✔ $100 or 25% of cost. _ _ _ _ _ _
15) An entity that processes nonstandard health information they receive from another
_ _ _ _ _ _ _ _ _ _ _
entity into a standard is considered what? -- Answer ✔✔ Clearinghouse.
_ _ _ _ _ _ _ _ _ _
16) What is PHI? -- Answer ✔✔ Personal Health Information.
_ _ _ _ _ _ _ _
17) Intentional billing of services not provided is considered? -- Answer ✔✔ Fraud.
_ _ _ _ _ _ _ _ _ _ _
18) What OIG document should a provider review for potential problem areas that will
_ _ _ _ _ _ _ _ _ _ _ _ _
receive special scrutiny in the upcoming year? -- Answer ✔✔ OIG Work Plan. Each
_ _ _ _ _ _ _ _ _ _ _ _ _ _
year in October.
_ _
19) What is ABN? -- Answer ✔✔ Advance Beneficiary Notification
_ _ _ _ _ _ _ _
20) What is AMA? -- Answer ✔✔ American Medical Association.
_ _ _ _ _ _ _ _
21) What is CPC? -- Answer ✔✔ Current Procedural Terminology. What was done into
_ _ _ _ _ _ _ _ _ _ _ _ _
codes.
22) What is ICD-9-CM? -- Answer ✔✔ International Classification of Disease, 9th
_ _ _ _ _ _ _ _ _ _ _
Clinical Modification. Why was done in codes.
_ _ _ _ _ _
FULLY SOLVED ANSWERS.
1) What is Part A? -- Answer ✔✔ Medicares's Hospital Insurance; covers hospital/facility
_ _ _ _ _ _ _ _ _ _ _
care.
_
2) What is Part B? -- Answer ✔✔ Medicare's Supplemental Medical Insurance; covers
_ _ _ _ _ _ _ _ _ _ _ _
physician services and durable medical equipment that are not paid for under Part A.
_ _ _ _ _ _ _ _ _ _ _ _ _
3) What is Part C? -- Answer ✔✔ Medicare's Advantage is a set of health care options
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
from which beneficiaries choose health care providers.
_ _ _ _ _ _
4) What is Part D? -- Answer ✔✔ Medicare's prescription drug program.
_ _ _ _ _ _ _ _ _ _
5) What is WHO? -- Answer ✔✔ World Health Organization. A group that deals with
_ _ _ _ _ _ _ _ _ _ _ _ _ _
health care issues on a global basis.
_ _ _ _ _ _
6) Volume 1 of ICD-9-CM contains what? -- Answer ✔✔ Tabular List: Diagnosis codes
_ _ _ _ _ _ _ _ _ _ _ _ _
organized in order by code. _ _ _ _
7) Volume 2 of ICD-9-CM contains what? -- Answer ✔✔ Index to Diseases: Diagnosis
_ _ _ _ _ _ _ _ _ _ _ _ _
codes organized in an alphabetic index.
_ _ _ _ _
8) Volume 3 of ICD-9-VM contains what? -- Answer ✔✔ Alphabetic Index and Tabular
_ _ _ _ _ _ _ _ _ _ _ _ _
Index of Procedures: Procedures performed in the inpatient setting.
_ _ _ _ _ _ _ _
9) V codes -- Answer ✔✔ Codes used to describe circumstances or condition that
_ _ _ _ _ _ _ _ _ _ _ _ _
could influence patient care.
_ _ _
, 10) When should an ABN be signed? -- Answer ✔✔ When a service is not expected to
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
be covered by Medicare.
_ _ _
11) What are NCD's interpreted at the MAC level considered? -- Answer ✔✔ LCD
_ _ _ _ _ _ _ _ _ _ _ _
12) What is medical billing? -- Answer ✔✔ Translating medical documentation into codes.
_ _ _ _ _ _ _ _ _ _ _
13) What part of Medicare should be billed for the pain medication by the pharmacy? --
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Answer ✔✔ Part D _ _ _
14) The amount on an ABN should be within how much of the cost to the patient? --
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Answer ✔✔ $100 or 25% of cost. _ _ _ _ _ _
15) An entity that processes nonstandard health information they receive from another
_ _ _ _ _ _ _ _ _ _ _
entity into a standard is considered what? -- Answer ✔✔ Clearinghouse.
_ _ _ _ _ _ _ _ _ _
16) What is PHI? -- Answer ✔✔ Personal Health Information.
_ _ _ _ _ _ _ _
17) Intentional billing of services not provided is considered? -- Answer ✔✔ Fraud.
_ _ _ _ _ _ _ _ _ _ _
18) What OIG document should a provider review for potential problem areas that will
_ _ _ _ _ _ _ _ _ _ _ _ _
receive special scrutiny in the upcoming year? -- Answer ✔✔ OIG Work Plan. Each
_ _ _ _ _ _ _ _ _ _ _ _ _ _
year in October.
_ _
19) What is ABN? -- Answer ✔✔ Advance Beneficiary Notification
_ _ _ _ _ _ _ _
20) What is AMA? -- Answer ✔✔ American Medical Association.
_ _ _ _ _ _ _ _
21) What is CPC? -- Answer ✔✔ Current Procedural Terminology. What was done into
_ _ _ _ _ _ _ _ _ _ _ _ _
codes.
22) What is ICD-9-CM? -- Answer ✔✔ International Classification of Disease, 9th
_ _ _ _ _ _ _ _ _ _ _
Clinical Modification. Why was done in codes.
_ _ _ _ _ _
