AAPC OFFICIAL CPC CERTIFICATION
STUDY GUIDE NOTES
"hold kharmless kclause" k- kcorrect kanswers k-* kfound kin ksome knon-Medicare khealth
kplan kcontracts
* kprohibits kbilling kto kpatient kfor kanything kbeyond kdeductibles kand kco-pays.
A kcompliance kplan kmay koffer kseveral kbenefits, kincluding: k- kcorrect kanswers k-*
kmore kaccurate kpayment kof kclaims
* kfewer kbilling kmistakes
* kimproved kdocumentation kand kmore kaccurate kcoding
* kless kchance kof kviolating kself-referral kand kanti-kickback kstatus
A khealthcare kclearing khouse kis ka k- kcorrect kanswers k-entity kthat kprocesses
knonstandard khealth kinformation kthey kreceive kfrom kanother kentity kinto ka kstandard
kformat
, A kkey kprovision kin kHIPAA kis kthe kMinimum kNecessary krequirement. kthis kmeans k-
kcorrect kanswers k-only kthe kminimum knecessary kprotected khealth kinformation
kshould kbe kshared kto ksatisfy ka kparticular kpurpose.
A kmedically knecessary kservice kis kthe k- kcorrect kanswers k-least kradical
kservice/procedure kthat kallows kfor keffective ktreatment kof kthe kpatients' kcomplaint kor
kcondition
A kpatient ksustaining kan kinjury kto kher kgreat ksaphenous kvein kwould khave
ksustained kinjury kto kwhich kof kanatomical ksite? k- kcorrect kanswers k-Leg
APC k- kcorrect kanswers k-Ambulatory kPayment kClassification
ARRA k- kcorrect kanswers k-American kRecovery kand kReinvestment kAct k(of k2009)
ASC k- kcorrect kanswers k-Ambulatory kSurgical kCenters
Abuse kconsists kof k- kcorrect kanswers k-payment kfor kitems kor kservices kthat kare
kbilled kby kproviders kin kerror kthat kshould knot kbe kpaid kfor kby kMedicare.
An kABN kprotects kthe kprovider's kfinancial kinterest kby k- kcorrect kanswers k-creating
ka kpaper ktrail kthat kCMS krequires kbefore ka kprovider kcan kbill kthe kpatient kfor
kpayment kif kMedicare kdenies kcoverage kfor kthe kstated kservice kor kprocedure.
An kentity kthat kprocesses knonstandard khealth kinformation kthey kreceive kfrom
kanother kentity kinto ka kstandard kformat kis kconsidered kwhat? k- kcorrect kanswers k-
Clearinghouse
As ka kpart kof kHealth kCare kReform, kthe kAffordable kCare kAct kof k2010 kamended
kthe kdefinition kof kfraud kto kremove kthe k__________ krequirement k- kcorrect kanswers
k-intent
By kstatute, kall kwork kRVUs, kmust kbe kexamined kno kless koften kthan k- kcorrect
kanswers k-every k5 kyears
CF k- kcorrect kanswers k-Coversion kFactor k- kfixed kdollar kamount kused kto ktranslate
kthe kRVUs kinto kfees
CMS k- kcorrect kanswers k-Centers kfor kMedicare kand kMedicaid
CMS kdeveloped kpolices kregarding kmedical knecessity kare kbased kon kregulations
kfound kin ktitle kXVIII, k$1862(a) kof kthe k- kcorrect kanswers k-Social kSecurity kAct
CMS kwill kaccept kthe k____________ kfor keither ka k"potentially knon=covered" kservice
kor kfor ka kstatutorily kexcluded kservice k- kcorrect kanswers k-CMS-R-131
STUDY GUIDE NOTES
"hold kharmless kclause" k- kcorrect kanswers k-* kfound kin ksome knon-Medicare khealth
kplan kcontracts
* kprohibits kbilling kto kpatient kfor kanything kbeyond kdeductibles kand kco-pays.
A kcompliance kplan kmay koffer kseveral kbenefits, kincluding: k- kcorrect kanswers k-*
kmore kaccurate kpayment kof kclaims
* kfewer kbilling kmistakes
* kimproved kdocumentation kand kmore kaccurate kcoding
* kless kchance kof kviolating kself-referral kand kanti-kickback kstatus
A khealthcare kclearing khouse kis ka k- kcorrect kanswers k-entity kthat kprocesses
knonstandard khealth kinformation kthey kreceive kfrom kanother kentity kinto ka kstandard
kformat
, A kkey kprovision kin kHIPAA kis kthe kMinimum kNecessary krequirement. kthis kmeans k-
kcorrect kanswers k-only kthe kminimum knecessary kprotected khealth kinformation
kshould kbe kshared kto ksatisfy ka kparticular kpurpose.
A kmedically knecessary kservice kis kthe k- kcorrect kanswers k-least kradical
kservice/procedure kthat kallows kfor keffective ktreatment kof kthe kpatients' kcomplaint kor
kcondition
A kpatient ksustaining kan kinjury kto kher kgreat ksaphenous kvein kwould khave
ksustained kinjury kto kwhich kof kanatomical ksite? k- kcorrect kanswers k-Leg
APC k- kcorrect kanswers k-Ambulatory kPayment kClassification
ARRA k- kcorrect kanswers k-American kRecovery kand kReinvestment kAct k(of k2009)
ASC k- kcorrect kanswers k-Ambulatory kSurgical kCenters
Abuse kconsists kof k- kcorrect kanswers k-payment kfor kitems kor kservices kthat kare
kbilled kby kproviders kin kerror kthat kshould knot kbe kpaid kfor kby kMedicare.
An kABN kprotects kthe kprovider's kfinancial kinterest kby k- kcorrect kanswers k-creating
ka kpaper ktrail kthat kCMS krequires kbefore ka kprovider kcan kbill kthe kpatient kfor
kpayment kif kMedicare kdenies kcoverage kfor kthe kstated kservice kor kprocedure.
An kentity kthat kprocesses knonstandard khealth kinformation kthey kreceive kfrom
kanother kentity kinto ka kstandard kformat kis kconsidered kwhat? k- kcorrect kanswers k-
Clearinghouse
As ka kpart kof kHealth kCare kReform, kthe kAffordable kCare kAct kof k2010 kamended
kthe kdefinition kof kfraud kto kremove kthe k__________ krequirement k- kcorrect kanswers
k-intent
By kstatute, kall kwork kRVUs, kmust kbe kexamined kno kless koften kthan k- kcorrect
kanswers k-every k5 kyears
CF k- kcorrect kanswers k-Coversion kFactor k- kfixed kdollar kamount kused kto ktranslate
kthe kRVUs kinto kfees
CMS k- kcorrect kanswers k-Centers kfor kMedicare kand kMedicaid
CMS kdeveloped kpolices kregarding kmedical knecessity kare kbased kon kregulations
kfound kin ktitle kXVIII, k$1862(a) kof kthe k- kcorrect kanswers k-Social kSecurity kAct
CMS kwill kaccept kthe k____________ kfor keither ka k"potentially knon=covered" kservice
kor kfor ka kstatutorily kexcluded kservice k- kcorrect kanswers k-CMS-R-131
