AAPC OFFICIAL CPC CERTIFICATION
STUDY GUIDE NOTES EXAM
QUESTIONS AND ANSWERS
If an inbuilding pharmacy delivers medication (for home use) to an individual
receiving outpatient chemotherapy, which part of Medicare should be billed for the
pain medication by the pharmacy? - Answer-Part D
Incus, stapes, _____ - Answer-malleus
Intentional billing of services not provided is considered - Answer-
LCD - Answer-Local Coverage Determinations
LCDs have jurisdiction only within - Answer-their regional area
LCDs give guidance when - Answer-* a given service is indicated or necessary,
* give guidance on coverage limitations
* describe the specific CPT codes to which the policy applies
* lists IICD-9-CM codes that support medical necessity for the given service or
procedure
MP - Answer-Malpractice
MS-DRG - Answer-Medical Severity-Diagnosis Related Group
Medicaid is a - Answer-a health insurance assistance program for some low-income
people
Medicaid is adminisitered on a - Answer-state by state basis adhering to certain
federal guidelines.
Medicare Part B helps to cover - Answer-medically necessary physicians' services
ouptatient care
other medical services (including some preventative services) not covered under
Part A
Medicare Part B premiums are paid by - Answer-the patient
Medicare Part C combines the benefits of - Answer-Part A and Part B and
sometimes Part D
Medicare Part C is also called - Answer-Medicare Advantage
, Medicare Part C plans are managed by - Answer-private insurers approved by
Medicare.
Medicare Part D is a - Answer-prescription drug coverage program
Medicare Part D is a coverage provided by - Answer-private companies approved by
Medicare
HIPAA stands for - Answer-Health Insurance Portability and Accountability Act of
1996
HITECH - Answer-The Health Information Technology for Economic and Clinical
Health Act
HITECH allows patients to request - Answer-an audit trail showing all disclosures of
their health information made through an electronic record.
HITECH requires that an individual be notified if - Answer-there is an unauthorized
disclosure or use of his or her health information.
HITECH was enacted as part of - Answer-the American Recovery and Reinvestment
Act of 2009 (ARRA)
HMO - Answer-Health Maintenence Organization
Hemiplegia is a disorder caused by a defect in which anatomic system? - Answer-
nervous
ICD-9-CM - Answer-International Classification of Disease, 9th Clinical Modification
IF:
Work RVUs = 0.48
Work GPCI = 1.000
Practice Expense CPCI = 0.943
MP GPCI = 0.572
transitioned non-facility practice RVUs = 0.70
Calculate non-facility pricing amount for cpt code 99212 using 2011 CF of $33.9764 -
Answer-$39.51 Non-facility pricing amount
(physician office, private practice)
STUDY GUIDE NOTES EXAM
QUESTIONS AND ANSWERS
If an inbuilding pharmacy delivers medication (for home use) to an individual
receiving outpatient chemotherapy, which part of Medicare should be billed for the
pain medication by the pharmacy? - Answer-Part D
Incus, stapes, _____ - Answer-malleus
Intentional billing of services not provided is considered - Answer-
LCD - Answer-Local Coverage Determinations
LCDs have jurisdiction only within - Answer-their regional area
LCDs give guidance when - Answer-* a given service is indicated or necessary,
* give guidance on coverage limitations
* describe the specific CPT codes to which the policy applies
* lists IICD-9-CM codes that support medical necessity for the given service or
procedure
MP - Answer-Malpractice
MS-DRG - Answer-Medical Severity-Diagnosis Related Group
Medicaid is a - Answer-a health insurance assistance program for some low-income
people
Medicaid is adminisitered on a - Answer-state by state basis adhering to certain
federal guidelines.
Medicare Part B helps to cover - Answer-medically necessary physicians' services
ouptatient care
other medical services (including some preventative services) not covered under
Part A
Medicare Part B premiums are paid by - Answer-the patient
Medicare Part C combines the benefits of - Answer-Part A and Part B and
sometimes Part D
Medicare Part C is also called - Answer-Medicare Advantage
, Medicare Part C plans are managed by - Answer-private insurers approved by
Medicare.
Medicare Part D is a - Answer-prescription drug coverage program
Medicare Part D is a coverage provided by - Answer-private companies approved by
Medicare
HIPAA stands for - Answer-Health Insurance Portability and Accountability Act of
1996
HITECH - Answer-The Health Information Technology for Economic and Clinical
Health Act
HITECH allows patients to request - Answer-an audit trail showing all disclosures of
their health information made through an electronic record.
HITECH requires that an individual be notified if - Answer-there is an unauthorized
disclosure or use of his or her health information.
HITECH was enacted as part of - Answer-the American Recovery and Reinvestment
Act of 2009 (ARRA)
HMO - Answer-Health Maintenence Organization
Hemiplegia is a disorder caused by a defect in which anatomic system? - Answer-
nervous
ICD-9-CM - Answer-International Classification of Disease, 9th Clinical Modification
IF:
Work RVUs = 0.48
Work GPCI = 1.000
Practice Expense CPCI = 0.943
MP GPCI = 0.572
transitioned non-facility practice RVUs = 0.70
Calculate non-facility pricing amount for cpt code 99212 using 2011 CF of $33.9764 -
Answer-$39.51 Non-facility pricing amount
(physician office, private practice)
