HIT 101 -DeVry University-Illinois AAPC Official CPC
Certification Study Guide Notes EXAM 2026-2027 IT
COVERS ALL CHAPTERS WITH REAL QUESTIONS
AND CORRECT DETAILED ANSWERS (CORRECT
VERIFIED ANSWERS) LATEST UPDATED VERSION
|ALREADY A GRADED {FULL REVISED EXAM
EDITION}
ASC
Ambulatory Surgical Centers
Abuse consists of
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
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?
Clearinghouse
As a part of Health Care Reform, the Affordable Care Act of 2010
amended the definition of fraud to remove the requirement
intent
By statute, all work RVUs, must be examined no less often than
every 5 years
CF
Coversion Factor - fixed dollar amount used to translate the RVUs
into fees
CMS
Centers for Medicare and Medicaid
CMS developed polices regarding medical necessity are based on
regulations found in title XVIII, $1862(a) of the
Social Security Act
,CMS will accept the ____________ for either a "potentially non=covered"
service or for a statutorily excluded service
CMS-R-131
CMS-R-131
ABN form
or
Advance Beneficiary Notice which explains to the patient why
Medicare may deny the particular service or procedure.
CPT
Current Procedural Terminology
CY 2013 Conversion Factor
$25.0008
Commercial (non-Medicare) may develop their own medical
policies which do not follow Medicare guidelines and are
specified in
private contracts between the payer and practice or provider
, DRG
Diagnosis Related Group
Does Medicare Part B generally require a yearly deductable and
copayment?
yes
E/M OR E&M
Evaluation and Management
EHR
Electronic Health Record
Formula for Calculating Facility Payment amounts
[(Work RVU Work GPCI) + (Transitioned Facility PE RVU PE GPCI) + (MP
RVU MP GPCI)] CF
Formula for Non-Facility Pricing Amount
[(Work RVU Work GPCI) + (Transitioned Non-Facility PE RVU PE GPCI) +
(MP RVU MP GPCI)] (CF)
Certification Study Guide Notes EXAM 2026-2027 IT
COVERS ALL CHAPTERS WITH REAL QUESTIONS
AND CORRECT DETAILED ANSWERS (CORRECT
VERIFIED ANSWERS) LATEST UPDATED VERSION
|ALREADY A GRADED {FULL REVISED EXAM
EDITION}
ASC
Ambulatory Surgical Centers
Abuse consists of
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
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?
Clearinghouse
As a part of Health Care Reform, the Affordable Care Act of 2010
amended the definition of fraud to remove the requirement
intent
By statute, all work RVUs, must be examined no less often than
every 5 years
CF
Coversion Factor - fixed dollar amount used to translate the RVUs
into fees
CMS
Centers for Medicare and Medicaid
CMS developed polices regarding medical necessity are based on
regulations found in title XVIII, $1862(a) of the
Social Security Act
,CMS will accept the ____________ for either a "potentially non=covered"
service or for a statutorily excluded service
CMS-R-131
CMS-R-131
ABN form
or
Advance Beneficiary Notice which explains to the patient why
Medicare may deny the particular service or procedure.
CPT
Current Procedural Terminology
CY 2013 Conversion Factor
$25.0008
Commercial (non-Medicare) may develop their own medical
policies which do not follow Medicare guidelines and are
specified in
private contracts between the payer and practice or provider
, DRG
Diagnosis Related Group
Does Medicare Part B generally require a yearly deductable and
copayment?
yes
E/M OR E&M
Evaluation and Management
EHR
Electronic Health Record
Formula for Calculating Facility Payment amounts
[(Work RVU Work GPCI) + (Transitioned Facility PE RVU PE GPCI) + (MP
RVU MP GPCI)] CF
Formula for Non-Facility Pricing Amount
[(Work RVU Work GPCI) + (Transitioned Non-Facility PE RVU PE GPCI) +
(MP RVU MP GPCI)] (CF)
